Study: Young teens more susceptible to opioid addiction

James David Dickson
The Detroit News

Young teenagers who use opioids for non-medical reasons are more likely to become addicted compared with older teens and young adults, according to a Michigan State University study.

“Peak risk for a transition from start of (nonmedical) use to opioid dependence within 12 months is seen at mid-adolescence among 14-to-15-year olds, somewhat earlier than peak risk for starting (non-medical) use,” which is 16-to-19-year olds, according to the study, released last week.

What that means is, young teens who start taking opioids beyond a doctor’s instructions, or to get high, are at the greatest risk of getting hooked, while older teenagers and young adults are at the greatest risk of coming across opioids to use non-medically in the first place.

Extra-medical use of painkiller is described, by the research team that pioneered the term, as: “One, without a doctor’s prescription; two, in greater amounts than prescribed; three, more often than prescribed; four, for any other reason than a doctor said you should take them — such as for kicks, to get high, or curiosity about the pill’s effect.”

Researchers at MSU’s department of epidemiology and biostatistics crunched more than a decade worth of data, the 2002-2013 National Surveys on Drug Use and Health, an annual survey published by the Substance Abuse and Mental Health Services Administration of the U.S. Department of Health and Human Services. The data encompassed some 42,000 12-to-21-year-olds.

The susceptibility to addiction among teenagers who use painkillers non-medically is important, the study explained, because in recent years the growth of painkiller-related deaths has come at the expense of people using the drugs non-medically. The study estimates that some 4 percent of 12-to-21-year-olds “qualify as active (non-medical) users” of painkillers.

Maria Parker, a Ph.D student who served as a researcher for the study, noted that peak susceptibility for teens comes in the early years of high school.

Peak access to the drugs comes as students are in the later years of high school, or have graduated, the study says.

While the study gives no insight as to how youths obtain the painkillers in the first place — leftovers from a legitimate prescription and drug diversion are both possibilities — Parker said doctors could be more vigilant in their prescribing practices.

“One way to limit the circulation of painkillers is by limiting the amount prescribed,” Parker said. She said prescribing in small doses and requiring contact with the doctor before new prescriptions are written could help.

It’s an approach some states, including Michigan, already take.

In Michigan, a doctor can’t write a prescription longer than 30 days for a Schedule II drug, the type with the greatest risk of misuse. Examples of this class of medication include oxycodone and Adderall.

The most physicians can do for Schedule II drugs is write three, 30-day prescriptions: one fillable today, the next in 30 days, the last in 60 days.

Beyond that, doctors have great discretion to write prescriptions in small amounts, requiring additional visits to the pharmacist — and possibly additional co-pays each time — explained Dr. Carmen McIntyre, chief medical officer for the Detroit Wayne Mental Health Authority.

McIntyre said a doctor worried about a patient’s use of drugs can write a prescription so that the person can only get seven days of drugs at a time.

“I can try to make sure you never have enough to OD on,” McIntyre said.

A patient who blows through a prescription would have to wait until the seven-day period expired, during which they may go into withdrawal and their pain might return.

For Schedule III, IV and V drugs, however, doctors can write prescriptions for up to 90 days, “which is not a good thing,” McIntyre said.

In Tennessee, doctors can generally only write prescriptions for up to 120 morphine milligram equivalents per day. Beyond that, a patient must see a pain specialist at least once a year. Michigan has no such limitations, McIntyre said.