Chronic pain in adolescence is tied to later opioid misuse

  • J Pain

  • curated by Emily Willingham, PhD
  • Clinical Essentials
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Takeaway

  • Chronic pain in adolescence is tied to later opioid misuse.
  • Depressive, anxiety symptoms are not predictive.

Why this matters

  • Early targeted screening might decrease opioid misuse.

Key results

  • 28.3% of adults (weighted percentage) in this study reported prescription opioid misuse.
  • 24% of those reporting chronic pain in adolescence reported opioid misuse in early adulthood vs 18.8% among those without such a history (P<.001>
    • aOR, 1.24 (95% CI, 1.05-1.46; P=.013).
  • Use in adulthood generally was also higher among those with chronic pain history: 33% vs 27% (P<.001>
    • aOR, 1.19 (95% CI, 1.04-1.36; P=.01).
  • Women were less likely to misuse (aOR, 0.67; 95% CI, 0.52-0.86).  
  • A history of childhood trauma increased odds (aOR, 1.38; 95% CI, 1.21-1.58).
  • Black, Hispanic participants were less likely to report misuse vs white participants:
    • Black adolescents: aOR, 0.40 (95% CI, 0.23-0.69); 
    • Hispanic adolescents: aOR, 0.42 (95% CI, 0.25-0.71).
  • Depression, anxiety, self-reported fair-poor physical health were not tied to misuse.

Study design

  • National Longitudinal Study of Adolescent to Adult Health data for 14,784 participants. 
  • Primary outcome: prescription opioid use in early adulthood and adulthood.
  • Funding: International Association for the Study of Pain; NIH.

Limitations

  • Self-report for opioid misuse.
  • Questions assessing opioid misuse differed for different cohorts (waves).

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