Opioid treatment during adolescence and young adulthood may be associated with a small increased risk of subsequent substance-related morbidity, suggests a study published in JAMA Pediatrics.
The cohort study analysed population-register data from 1 January 2007 to 31 December 2013 on Swedish individuals aged 13 to 29 years by January 1, 2013, who were naive to opioid prescription.
Among 1,541,862 participants, 193,922 initiated opioid therapy (median age at initiation, 20.9 years).
The active comparator included 77,143 opioid recipients without pre-existing substance-related morbidity and 229,461 recipients of nonsteroidal anti-inflammatory drugs (NSAIDs).
The adjusted cumulative incidence of substance-related morbidity within five years was 6.2 per cent (95% CI 5.9%-6.5%) for opioid recipients and 4.9 per cent (95% CI 4.8%-5.1%) for NSAIDs recipients (hazard ratio [HR] 1.29; 95% CI 1.23-1.35).
The co-twin control design produced comparable results for opioid recipients and non-recipients (adjusted HR 1.43; 95% CI 1.02-2.01). Findings were similar when analysis was restricted to analgesics prescribed for dental indications and additional sensitivity analyses.
The findings indicate that initial opioid prescription in adolescence or young adulthood is associated with close to a 30-40 per cent relative increase in risk of subsequent substance-related morbidity.