title: Adolescent context of exposure to prescription opioids and substance use disorder symptoms at age 35: a national longitudinal study.
abstract: The objective of this study was to examine the association of context of prescription opioid exposure (ie, medical or nonmedical) in adolescence with the subsequent risk of nonmedical use of prescription opioids (NMUPO) and substance use disorder (SUD) symptoms at age 35. Multiple cohorts of nationally representative probability samples of U.S. high school seniors (n = 4072) were surveyed through self-administered questionnaires and followed longitudinally from adolescence (modal age 18, graduating classes 1976-1996) to age 35 (1993-2013). Main outcome measures were past-year NMUPO and SUD symptoms. The medical and NMUPO during adolescence was significantly associated with NMUPO at age 35. Relative to no prescription opioid exposure, medical use of prescription opioids without any history of NMUPO during adolescence was not associated with SUD symptoms at age 35. In contrast, compared with no prescription opioid exposure during adolescence, the adjusted odds ratios (AORs) associated with SUD symptoms at age 35 were greater among those with a history of both medical use of prescription opioids and NMUPO during adolescence, AOR = 1.49 (95% CI = 1.13-1.97); and among those who reported NMUPO only, AOR = 2.61 (95% CI = 1.88-3.61). The findings indicate medical use of prescription opioids without any history of NMUPO in adolescence is not associated with SUD symptoms at age 35, whereas any NMUPO in adolescence predicts SUD symptoms at age 35. Screening instruments and preventive intervention programs to reduce NMUPO and SUDs must account for the context associated with prescription opioid exposure during adolescence.
authors.affiliation: Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI, USA.|Substance Abuse Research Center, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Sean Esteban
authors.initials: SE
authors.lastname: McCabe
authors.affiliation: Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Philip
authors.initials: P
authors.lastname: Veliz
authors.affiliation: Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.|Department of Psychology, University of Michigan, Ann Arbor, MI, USA.
authors.forename: John E
authors.initials: JE
authors.lastname: Schulenberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D009293:Opioid-Related Disorders / Q000453:epidemiology*; D063487:Prescription Drug Misuse / Q000706:statistics & numerical data* / Q000639:trends*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
chemical_list: D000701:Analgesics, Opioid