Heterogeneity in Prescription Opioid Misuse Motives by Age in Adolescents and Young Adults in the United States.

Abstract

Objective: Adolescent (12-17 years) and young adult (18-25 years) prescription opioid misuse (POM) is linked to poor health outcomes. We investigated how POM motives vary across these ages and the potential links between motives and other substance use, mental health, and sociodemographic characteristics to help guide screening and prevention.

Methods: Pooled 2015-2019 US National Survey on Drug Use and Health data were used, with 137,858 participants. Cross-tabulations estimated prevalence of individual motives and motive category by age. Mutually exclusive motive categories were no past-year POM, pain relief only, pain/sleep/relax (ie, some combination of only these motives), and any non-self-treatment motives (eg, get high, experiment). Logistic regression models evaluated links between motive category and sociodemographic, mental health, and substance use (eg, alcohol, cannabis, nicotine, other prescription misuse) outcomes by age group, versus reference groups of no past-year POM or pain relief only.

Results: Pain relief was the most common POM motive (estimated at >50% at all ages), but POM for non-self-treatment motives was the most common category after 14 years. POM for non-self-treatment motives had the highest adjusted odds ratios (aORs) of all substance use and mental health characteristics (eg, past-year substance use disorder aORs of 6.11 in adolescents [95% confidence interval (CI), 4.23-8.85] and 4.81 [95% CI, 4.01-5.77] in young adults, versus the pain relief only reference).

Conclusions: POM for any non-self-treatment motives is linked to the highest prevalence of other substance use and mental health concerns, whereas POM for pain relief also signals a need for substance use and mental health screening.