title: Opioid abuse and depression in adolescents: Results from the National Survey on Drug Use and Health.
abstract: OBJECTIVE
  To investigate the association of major depressive episode (MDE) with nonmedical prescription opioid use (NMPOU) and opioid abuse/dependence among adolescents aged 12 to 17.
  
  
  METHODS
  We analyzed 5 years of data from the National Survey on Drug Use and Health (NSDUH). We used logistic regressions to study the relationship between MDE and NMPOU among all adolescents, as well as the relationship of MDE with opioid abuse/dependence among adolescents with NMPOU. Other covariates included: sociodemographics, alcohol abuse/dependence, nonopioid drug abuse/dependence, delinquency, school performance, religious services attendance, and family support/supervision.
  
  
  RESULTS
  In the sample of all adolescents, 6% reported past year NMPOU, and 8% reported past year MDE. When NMPOU and MDE were comorbid, MDE usually preceded the NMPOU. In the sample of adolescents with NMPOU, 15% reported past year opioid abuse/dependence, and 20% reported past year MDE. In adjusted logistic regression, MDE was associated with both NMPOU (OR=1.51, p<0.001) among all adolescents and opioid abuse/dependence (OR=2.18, p<0.001) among adolescents with NMPOU.
  
  
  CONCLUSIONS
  MDE occurs commonly in adolescents and is associated with NMPOU and opioid abuse/dependence. In terms of population attributable risk, which is a function of both the prevalence and the strength of the association, MDE is an important risk factor for NMPOU among adolescents and opioid abuse/dependence among adolescents with NMPOU. Preventive and clinical programs to decrease NMPOU and opioid abuse/dependence among adolescents should consider the prominent role of depression.
authors.affiliation: RTI International, Research Triangle Park, NC 27709-2194, United States. Electronic address: medlund@rti.org.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Edlund
authors.affiliation: RTI International, Research Triangle Park, NC 27709-2194, United States.
authors.forename: Valerie L
authors.initials: VL
authors.lastname: Forman-Hoffman
authors.affiliation: RTI International, Research Triangle Park, NC 27709-2194, United States.
authors.forename: Cherie R
authors.initials: CR
authors.lastname: Winder
authors.affiliation: RTI International, Research Triangle Park, NC 27709-2194, United States.
authors.forename: David C
authors.initials: DC
authors.lastname: Heller
authors.affiliation: RTI International, Research Triangle Park, NC 27709-2194, United States.
authors.forename: Larry A
authors.initials: LA
authors.lastname: Kroutil
authors.affiliation: Substance Abuse and Mental Health Services Administration, Rockville, MD 20857, United States.
authors.forename: Rachel N
authors.initials: RN
authors.lastname: Lipari
authors.affiliation: National Institute of Mental Health, Bethesda, MD 20892, United States.
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Colpe
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000437:Alcoholism / Q000453:epidemiology; D002648:Child; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology*; D004522:Educational Status; D005190:Family; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D009293:Opioid-Related Disorders / Q000453:epidemiology*; D063487:Prescription Drug Misuse / Q000706:statistics & numerical data; D012067:Religion; D012737:Sex Factors; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
keywords: Adolescent; Depression; Drug abuse; Opioid-related disorders; Prescription drug misuse