Are Teens With Mental Health Issues More Likely To Be Prescribed Opioids?

By Paul Fuhr 03/15/18

Researchers made an interesting discovery while studying healthcare insurance claims from teens with mental health issues.

Image: 
woman taking a pill

Young people with certain pre-existing mental health conditions are more likely than others to receive large quantities of opioids and, therefore, find themselves in long-term opioid therapy programs.

That’s according to a new study out of Indiana University in Bloomington, where Dr. Patrick Quinn and his fellow researchers discovered that the prescription of opioids increased for any adolescents struggling with mood, anxiety, sleep, and non-opioid substance use disorders, MedPage Today reported.

“While overall rates of long-term opioid therapy were low among recipients, adolescents with these pre-existing mental health conditions and treatments were more likely to transition to long-term opioid therapy,” the story said.

Researchers analyzed data from commercial healthcare insurance claims between the years of 2003 and 2014, identifying a block of adolescents (14-18 years) who were prescribed opioids without being diagnosed with cancer. 

According to MedPage Today, researchers described long-term opioid therapy as having more than 90 days’ worth of an opioid supply within a six-month period. (Additionally, there were no gaps in the supply greater than 32 days.)

Researchers studied nearly 1.2 million of adolescents who were prescribed an opioid, of which nearly 50% were girls with an average age of 17. Researchers discovered that there were only three primary opioids prescribed: hydrocodone, oxycodone and codeine.

“Hydrocodone accounted for about 60% of opioids received among a little over 70% of recipients,” MedPage Today reported, “followed by a little over 20% of recipients receiving oxycodone and about 19% receiving codeine.”

All mental health conditions and treatments captured in the insurance claim database involved attention deficit-hyperactivity disorder (ADHD), benzodiazepines, non-opioid substance use disorders, non-benzodiazepine hypnotics and other disorders.

Interestingly, the study’s authors found virtually no connection between long-term opioid use and suicide, self-injury attempts, schizophrenia spectrum disorders, and opioid abuse.

Additionally, an editorial that accompanied the report advised next steps and best practices for pediatricians who might have patients transitioning to long-term opioid therapy.

“Conducting clinical interviews and routine screenings to identify factors associated with substance use and mental health issues should be a starting point for pediatric practitioners,” the editorial said. 

“Obtaining a profile of the adolescent’s close peer group or their peer network health (the sum of close peers’ risky and protective behaviors) would provide insight into important socially influenced risk and protective factors.” The report also cautioned pediatricians to consider such “age-related risk factors” like puberty.

The researchers, however, acknowledged that the report has some fundamental limitations to it—mainly that it’s based on insurance claims data which “likely underestimated prevalence of substance use disorder and other mental health conditions.”

Also, the study only focused on “claimed prescription fills,” which means it excludes medications obtained through other means, and loses sight of whether adolescents actually consumed their filled prescriptions.

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Paul Fuhr lives in Columbus, Ohio with his family and two cats, Vesper and Dr. No. He's written for AfterParty MagazineThe Literary Review and The Live Oak Review, among others. He's also the host of "Drop the Needle," a podcast about music and addiction recovery. More at paulfuhr.com. You can also find Paul on Linkedin and Twitter.

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