Patterns of Opioid Use in Adolescents Receiving Prescriptions: The Role of Psychological and Pain Factors

In the United States, adolescents are routinely prescribed opioids for management of pain. Data suggest that early opioid use, even via a legitimate prescription, can increase risk for opioid misuse. There are surprisingly little data on the nature of pain medication prescribing within pediatric medical settings and adolescent outcomes despite this being the place most youth are introduced to prescription opioids. To address this gap, the current study recruited n = 139 adolescents ages 14-18 years who were prescribed opioid medications for acute noncancer pain in pediatric outpatient medical settings. Data on opioid use and mood symptoms were obtained via daily diaries and self-report measures. The majority of youth (90.9%) filled the opioid prescription, and of those who used those opioids, the frequency of use varied widely (10-100% of days). There were no gender differences in the percent of opioid use days, despite females reporting higher pain and mood symptoms than males. Greater pain experiences and the number of pills prescribed were positively associated with opioid use as reported in daily diaries. As hypothesized, higher depressive symptoms were associated with greater opioid use. Higher daily reports of worried or scared affect were associated with lower opioid use. Findings contribute to our understanding of adolescent opioid use following prescription in a pediatric outpatient medical setting. Public Significance Statement This study suggests that higher depressive symptoms as well as prescription characteristics such as number of pills prescribed are associated with greater opioid use among adolescents who are prescribed opioid medications to treat acute pain. Additionally, results highlight gender differences in psychological and pain-related risk among this sample of adolescents with acute pain, which may inform the development of interventions to reduce opioid use.