A new study provides striking data about the misuse of potent prescription pain relievers and sedatives by teens and young adults.
In all, 10.4% of the teens and young adults treated in one ED for any reason admitted to misusing a prescription pain reliever or sedative at least once in the last year, according to researchers with the University of Michigan. Misuse included taking the drugs to get high, taking more of the drug than was prescribed to them and taking drugs prescribed to someone else.
The vast majority of those who admitted this use had no prescriptions for these drugs on their medical records, the researchers reported.
As published Oct. 28 on the website of the journal Pediatrics, researchers with the U-M Medical School and U-M Injury Center drew data from a large, confidential, tablet-based survey of 2,135 people ages 14 to 20. The survey was conducted in 2010-11 during visits to the U-M Health Systems adult and pediatric EDs.
The study is described as the first to examine the issue in an ED setting. The CDC has estimated that 100 deaths per day and around 700,000 ED visits per year result from prescription drug overdoses.
Lauren Whiteside, MD, who led the study during her U-M Injury Center postdoctoral research fellowship, said the findings suggest the ED could be an effective setting for screening teens and young adults for prescription drug misuse, and for intervening early before problems arise.
She also noted the importance of awareness by emergency clinicians of the risk that patients could be seeking drugs for misuse or diversion to others when they come to the ED.
The researchers asked teens and young adults about their use of the prescription opioids fentanyl, oxycodone, hydrocodone, methadone, buprenorphine, and suboxone, and the sedatives Valium, Serepax, Ativan, Xanax, Librium, Rohypnol and GHB, among others. Responses revealed several risk factors that were associated with non-medical use of prescription pain relievers and sedatives.
For instance, those who misused pain relievers were more likely to receive an intravenous opioid pain reliever during their ED visit. And across the board, those who misused prescription drugs were significantly more likely to have also abused alcohol and non-prescription drugs such as cough medicine, or to have used marijuana, in the past year. They also were more likely to have ridden with a drunk driver.
These patients are often using the emergency department for their medical care, not primary care settings, Whiteside said. So, in order to curb this problem and address overdose and addiction, the ED is a good place to start.
Whiteside, now with the University of Washington, noted that because the study was performed in one emergency setting, further study is needed to validate the findings. And more research to develop and test screening tools and interventional tactics will be needed.
It will likely take a concerted effort at the state level, with improved information systems aiding prescribing physicians to identify youth at risk, a change in prescribing practices that takes into account the epidemic and the public health crisis, and improved early screening and intervention to change the current rising trend of overdose deaths related to prescription medications, study co-author Rebecca Cunningham, MD, the U-M Injury Center director and an associate professor of emergency medicine, said in the news release.
Study (PDF): http://pediatrics.aappublications.org/content/early/2013/10/23/peds.2013-0721.full.pdf