Study Finds Three-Quarters of High School Heroin Users Started with Prescription Opioids

An increased risk for opioid misuse among adults who receive legitimate prescriptions has long been acknowledged as a possible consequence of opioid prescribing. Weighing and addressing this risk of iatrogenic opioid misuse is a key concern for medical professionals, and the risk figures prominently in opioid position articles published by professional medical organizations. One such position article recently revealed that the risk of future opioid misuse is so substantial that it outweighs the benefits of opioids for certain conditions, such as chronic back pain. Yet despite the importance of the risk associated with iatrogenic opioid misuse, estimates of the size of this risk for adolescents in the general population are not currently available.
This study estimates the risk of future opioid misuse associated with legitimate use of prescription opioids among adolescents who have not yet graduated high school. An association between legitimate opioid use before high school completion and an increased risk of subsequent misuse after high school could change the risk/benefit considerations for clinicians who treat pediatric patients with painful conditions. Using prospective, nationally representative cohorts, the analyses examine the future risk of opioid misuse among respondents with and without a history of legitimate use of prescription opioids by 12th grade. We stratify the analyses by adolescents’ levels of preexisting, baseline risk levels for future opioid misuse on the basis of drug use behaviors, attitudes, and other characteristics at the initial baseline survey. This analytic strategy builds on and contributes to the literature revealing that these individual-level factors strongly predict future opioid misuse by taking into account their potential confounding and moderating effects.

To see the full findings from the study, "Prescription Opioids in Adolescence and Future Opioid Misuse," published in the November 2015 issue of Pediatrics, visit: