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America's Children in Brief: Key National Indicators of Well-Being, 2018

Prescription Opioid Misuse and Use Disorders

Based on self-reported data, a recent study has reported downward national trends in substance (alcohol or illicit drug) use and use disorders among youth.27 In particular, recent studies have showed that marijuana and nonmarijuana illicit drug28 use and related use disorders declined among U.S. youth. However, little has been published to date about prescription opioid misuse and use disorders among youth in the United States. Since 1999, the United States has experienced increases in morbidity and mortality associated with prescription opioid misuse.29, 30, 31, 32 Youth are not exempt from this national problem.33, 34 During 2006–2012, approximately 22,000 emergency department visits by patients under age 18 were due to prescription opioid poisoning, and the majority of those visits by patients ages 15–17 were for intentional poisonings.33 Between 2005 and 2014, emergency department opioid misuse diagnoses increased among young people.34

Misuse of prescription opioids is defined as use in any way not directed by a doctor, including (1) use without a prescription of your own; (2) use in greater amounts, more often, or longer than you were told to take them; or (3) use in any other way a doctor did not direct. Prescription opioid use disorders are defined based on diagnostic criteria for prescription opioid dependence or abuse as specified in the 4th Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). These criteria include symptoms such as withdrawal, tolerance, use in dangerous situations, trouble with the law, and interference with major obligations at work, school, or home during the past 12 months. All youth with past-year prescription opioid use disorders are considered to have misused prescription opioids in the past year.35

Figure 7: Percentage of prescription opioid misuse and use disorders in the past year among youth ages 12–17 by sex and race and Hispanic origin, 2016
Percentage of prescription opioid misuse and use disorders in the past year among youth ages 12–17 by sex and race and Hispanic origin, 2016

NOTE: The National Survey on Drug Use and Health defined misuse of prescription opioids as "in any way that a doctor did not direct you to use them, including (1) use without a prescription of your own; (2) use in greater amounts, more often, or longer than you were told to take them; or (3) use in any other way a doctor did not direct you to use them." Past-year prescription opioid use disorders were defined based on the 11 diagnostic criteria for prescription opioid dependence or abuse as specified in the 4th Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). These included symptoms such as withdrawal, tolerance, use in dangerous situations, trouble with the law, and interference with major obligations at work, school, or home during the past 12 months.

SOURCE: Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health.

  • Among youth ages 12–17 in 2016, 0.9 million (3.5 percent) misused prescription opioids in the past 12 months. The prevalence of misuse of prescription opioids did not vary by sex and race/ethnicity.
  • Among youth ages 12–17 in 2016, the prevalence of prescription opioid use disorders did not vary by race/ethnicity, but it was higher among females (0.9 percent) than among males (0.3 percent).
  • The overall national prevalence of prescription opioid misuse and use disorders among adolescents ages 12–17 was unchanged between 2015 and 2016.

Figure 8: Percentage distribution of the source of prescription opioids obtained for the most recent misuse among youth ages 12–17 with past-year prescription opioid misuse, 2015 and 2016
Percentage distribution of the source of prescription opioids obtained for the most recent misuse among youth ages 12–17 with past-year prescription opioid misuse, 2015 and 2016

NOTE: The National Survey on Drug Use and Health defined misuse of prescription opioids as "in any way that a doctor did not direct you to use them, including (1) use without a prescription of your own; (2) use in greater amounts, more often, or longer than you were told to take them; or (3) use in any other way a doctor did not direct you to use them." The source of prescription opioids for the most recent episode of misuse was determined by asking respondents to respond to a multiple-choice question that offered the following options: given by a friend/relative for free, prescribed by physician(s), stolen from a friend/relative, bought from a friend/relative, bought from a drug dealer/stranger, or other way.

SOURCE: Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health.

  • In 2016, among past-year prescription opioid misusers ages 12–17, the most commonly reported sources of prescription opioids for their most recent misuse were friends or relatives for free (38.8 percent) and a doctor (21.2 percent). The percentages of these sources were similar in 2015 and 2016.
  • However, among past-year prescription opioid misusers ages 12–17, the percentage reporting that their most recent prescription opioids were bought from a dealer or a stranger increased from 5.1 percent in 2015 to 9.4 percent in 2016.

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27 Han, B., Compton, W. M., Blanco, C., & DuPont, R. (2017). National trends in substance use and use disorders among youth. Journal of the American Academy of Child & Adolescent Psychiatry, 56(9), 747–754.

28 Han, B., Compton, W. M., Jones, C. M., & Blanco, C. (2017). Cannabis use and cannabis use disorders among youth in the United States, 2002–2014. Journal of Clinical Psychiatry, 78(9),1404–1413.

29 Han, B., Compton, W. M., Jones, C. M., & Cai, R. (2015). Nonmedical prescription opioid use and use disorders among adults aged 18 through 64 years in the United States, 2003–2013. Journal of the American Medical Association, 314(14),1468–1478.

30 Rudd, R. A., Seth, P., David, F., & Scholl, L. (2016). Increases in drug and opioid-involved overdose deaths—United States, 2010–2015. Morbidity and Mortality Weekly Report, 65, 1445–1452.

31 Han, B., Compton, W. M., Blanco, C., Crane, E., Lee, J., & Jones, C. M. (2017). Prescription opioid use, misuse, and use disorders in U.S. adults: 2015 National Survey on Drug Use and Health. Annals of Internal Medicine, 167, 293–301.

32 Han, B., Compton, W. M., Blanco, C., & Jones, C. M. (2018). Correlates of prescription opioid use, misuse, and use disorders and motivations for misuse among U.S. adults. Journal of Clinical Psychiatry, 79 (5). Retrieved from https://www.psychiatrist.com/JCP/article/Pages/2018/v79/17m11973.aspx.

33 Tadros, A., Layman, S. M., Davis, S. M., Bozeman, R., & Davidov, D. M. (2016). Emergency department visits by pediatric patients for poisoning by prescription opioids. The American Journal of Drug and Alcohol Abuse, 42(5), 550–555.

34 Abbasi, J. (2017). Emergency department opioid misuse diagnoses increasing in adolescents and young adults. The Journal of the American Medical Association, 318(24), 2416–2417.

35 Substance Abuse and Mental Health Services Administration: National Survey on Drug Use and Health. Retrieved from https://www.samhsa.gov/data/data-we-collect/nsduh-national-survey-drug-use-and-health.