title: Predictors of Sustained Prescription Opioid Use After Admission for Trauma in Adolescents.
abstract: OBJECTIVE
  The study objectives are to describe the longitudinal trajectory of prescription opioid use among adolescents requiring a trauma admission and then identify predictors of sustained opioid use.
  
  
  METHODS
  Randomly sampled adolescents (12-18 years) admitted to a Level I trauma center were surveyed. Follow-up assessments were obtained at 2, 5, and 12 months. Self-reported prescription opioid use, defined as "taking an opioid prescribed by a physician," was obtained at baseline and every follow-up time point. At the baseline interview, validated mental health measures and pain scales were obtained as well as preinjury substance use. A fixed-effects mixed Poisson regression analysis was performed to predict prescription opioid use over time.
  
  
  RESULTS
  A total of 120 adolescents (mean age 15.5 years [1.9 standard deviation], 75% male) completed the baseline interview with 98% follow-up at 12 months. At baseline, 7% of adolescents reported prescription opioid use before their trauma, with rates of prescription opioid use of 52% at 2 months, 13.3% at 5 months, and 12.5% at 12 months after discharge. After adjusting for demographic characteristics and injury severity score, those with sustained prescription opioid use were more likely to report preinjury marijuana use and higher baseline pain scores.
  
  
  CONCLUSIONS
  Approximately one in eight adolescents (12.5%) was using prescription opioids 12 months after injury hospitalization. Readily identifiable risk factors predicted sustained prescription opioid use, including preinjury marijuana use and baseline pain score. Screening for substance use including marijuana at the time of injury could help identify patients at risk for both substance use problems and sustained prescription opioid use.
authors.affiliation: Department of Medicine, Division of Emergency Medicine, University of Washington, Seattle, Washington; Harborview Injury Prevention & Research Center, Seattle, Washington. Electronic address: laurenkw@uw.edu.
authors.forename: Lauren K
authors.initials: LK
authors.lastname: Whiteside
authors.affiliation: Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, Washington.
authors.forename: Joan
authors.initials: J
authors.lastname: Russo
authors.affiliation: Harborview Injury Prevention & Research Center, Seattle, Washington.
authors.forename: Jin
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Emergency Medicine, Alpert Medical School, Brown University, Providence, Rhode Island.
authors.forename: Megan L
authors.initials: ML
authors.lastname: Ranney
authors.affiliation: Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, Washington.
authors.forename: Victoria
authors.initials: V
authors.lastname: Neam
authors.affiliation: Harborview Injury Prevention & Research Center, Seattle, Washington; Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, Washington.
authors.forename: Douglas F
authors.initials: DF
authors.lastname: Zatzick
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D002648:Child; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008385:Marijuana Smoking; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control; D063487:Prescription Drug Misuse; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000209:etiology*; D011795:Surveys and Questionnaires; D014947:Wounds and Injuries / Q000188:drug therapy*
chemical_list: D000701:Analgesics, Opioid
keywords: Prescription opioid use; Substance use; Trauma/Injury