Factors ID'd putting youth on high-risk trajectory after first opioid prescription

(HealthDay)—High- and low-risk trajectories are identifiable for youth following their first opioid prescription, according to a study published online April 22 in JAMA Network Open.

J. Deanna Wilson, M.D., from the University of Pittsburgh, and colleagues evaluated patterns of opioid prescribing following the first prescription using group-based trajectory modeling and examined the patient-, clinician-, and prescription-level factors affecting first-year trajectories. Pennsylvania Medicaid enrollees' claims data (2010 through 2016) were used to identify 189,477 opioid-naive youths aged 10 to 21 years at the time of first opioid prescription.

The researchers found that during the subsequent year, 25.1 percent of individuals received at least one additional prescription. The two-group trajectory model had the best fit. Of those in the high-risk trajectory, 65.3 percent filled opioid prescriptions at month 12 versus 13.1 percent in the low-risk trajectory. The high-risk trajectory had a higher median age versus the low-risk trajectory (19.0 versus 17.8 years). Additionally, the high-risk trajectory received more potent prescriptions versus the low-risk trajectory (median dosage of the index month, 10.0 versus 4.7 morphine milligram equivalents/day, respectively). More youths in the high-risk trajectory went on to receive a diagnosis of opioid use disorder than the low-risk trajectory group beyond 12 months (30.0 versus 10.1 percent).

"Among the highest-risk trajectory, even short and low-dose opioid prescriptions were associated with increased risk of persistent opioid use," the authors write.

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