Award Winning Abstracts

Associations Between Opioid Prescribing Patterns and Opioid Overdose Among Adolescents in the USA

Cornelius B Groenewald, MB,ChB* and William C. Van Cleve MD MPH* †
*Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, Washington.
†Surgical Outcomes Research Center, University of Washington School of Medicine. ¶Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute.

Submitted by Cornelius B Groenewald, MB, ChB

Prescription opioid overdose is now a leading cause of injury-related mortality in the United States. Indeed, there are annually > 3,000 hospitalizations and >700 deaths due to prescription opioids among adolescents in the United States. However, it is unknown whether opioid prescribing patterns may contribute to this problem. This is an important gap in knowledge that has impeded public health efforts aimed at reducing the impact of the opioid epidemic affecting adolescents.

Therefore, we set out to determine whether the number of opioid tablets prescribed to opioid-naïve adolescents were associated with risk of opioid overdose. To answer this question we used data from the MarketScan database. MarketScan contains longitudinal data on health care use (including opioid use) by Americans with health insurance (>150 million patients). We found that 4 out of every 10, 000 adolescents experienced an overdose following an opioid prescription. As expected, adolescents’ risk of overdose increased if they received more opioids. For example those who received >30 tablets had a 50% higher chance of overdose as compared to those who received <15 tablets. We also found that risk for overdose increased with age and that females were at increased risk for overdose.

In summary: It appears that risk for overdose increases along with higher opioid dose among adolescents. Given that we performed cross-sectional analysis of an existing database our data has several limitations that should be addressed in future research. Nevertheless, findings highlight the need for guidelines aimed at reducing problematic opioid use among adolescents in the United States.