Youth with mental illness, substance-misuse histories at risk of opioid misuse

Opioid misuse is a devastating problem in the U.S. and a leading cause of death among adolescents and young adults. Penn State College of Medicine researchers found young people with certain mental health conditions and histories of substance misuse may have an increased risk of being diagnosed with an opioid use disorder (OUD) in a national study. Based on these findings, researchers stress the importance of early intervention and educating adolescents about the dangers of misusing opioids.

The investigators analyzed data from 4,926 privately-insured patients, 12 to 25 years old, who were clinically diagnosed with an OUD or opioid poisoning in 2017. They found that in the two years leading up to their diagnosis, the majority of patients (60.6%) received medical treatment for a mental health condition, such as anxiety or depression, or a substance use disorder (SUD) involving alcohol, tobacco or cannabis. According to the researchers, females were more likely than males to receive mental health treatment.

Since many patients were treated for non opioid-related health issues prior to their OUD diagnosis, the researchers said that opportunities exist for health care providers to screen, intervene and educate patients about opioids and opioid poisoning.

"Our findings highlight how often mental health conditions and other SUDs were identified prior to an OUD or opioid poisoning diagnosis," said co-author Edeanya Agbese, research project manager in the Department of Public Health Sciences and the Center for Applied Studies in Health Economics. "Taking advantage of these opportunities to intervene and develop more effective screening tools could reduce the chances of future opioid misuse among youths."

"Given that many adults with a substance use problem report first using substances in adolescence, early intervention could have a significant impact on the opioid epidemic," said co-author Douglas Leslie, professor of public health sciences and director of the Center for Applied Studies in Health Economics.

The researchers said doctors could screen for at-risk behaviors and implement prevention and intervention strategies early by targeting adolescents, young adults and their families. According to the researchers, it may also be beneficial for health care providers to discuss treatment options with families and increase access to naloxone, a medication used in emergencies to treat patients who overdose on opioids.

Bradley Stein and Andrew Dick from RAND Corporation; Benjamin Druss from Rollins School of Public Health at Emory University; and Rosalie Pacula from the Schaeffer Center for Health Policy and Economics at the University of Southern California contributed to this research.

This research was supported by the National Institute on Drug Abuse (grant R01DA047396). The Penn State researchers disclose no relevant conflicts of interest.