Adolescents and young adults who have family members with prescriptions for opioids are more likely to experience an overdose.
Publishing their findings in JAMA Network Open, Anh P. Nguyen, PhD, of the Institute for Health Research at Kaiser Permanente Colorado in Aurora, conducted a cohort study on 45,145 families enrolled in a Kaiser Permanente Colorado health plan in 2006 who were followed through June 2018.
The families included 72,040 adolescents and young adults ages 11 to 26 years old. They were 18 years old on average and were about evenly divided by sex. The average length of follow-up was 4.9 years.
During the follow-up period, 6.0% of the youths had a drug use disorder, 13% had a major depressive disorder, 13% had an anxiety disorder and 44% had one or more acute or chronic pain diagnoses. The pain diagnoses were primarily headaches or migraines, low back pain and knee pain.
Thirty-seven percent of the youths filled at least one opioid prescription, while 66% of youths had at least one family member who had a prescription.
The young people experienced 103 opioid-related overdoses during a cumulative 355,000 years of follow-up, including 65 overdoses among those with no opioid prescriptions in their household (during 321,000 cumulative years of follow-up); 16 among those with a family member with an opioid prescription (during 30,000 cumulative years of follow-up); 15 among youths with an opioid prescription but whose family members did not have one (during 5,000 cumulative years of follow-up); and seven among youths with an opioid prescription and with a family member who also had one (during 103 cumulative years of follow-up).
Fourteen of the overdoses were fatal.
After adjusting the data to account for various differences between the cohort members, the study authors found that exposure to a family member’s opioid prescription was associated with a 2.2-fold increased likelihood that youths would experience an overdose. Youths with their own prescription had a 6.6-fold increase risk of overdose.
While it was rare for youths to have an opioid prescription at the same time as family members, this scenario was associated with a 13.0-fold increased risk of overdose.
Compared with having no family members with an opioid prescription during the previous month, having a family member with a prescription of at least 600 morphine milligram equivalents (MMEs) was associated with a 2.9-fold increased risk of overdose among youths. Compared with youths without an opioid prescription during the previous month, youths with a prescription of 120 to 224 MMEs had a 5.2-fold increased likelihood of overdosing; having a prescription of at least 225 MMEs was associated with an 8.8-fold increased likelihood of overdosing.
“Further interventions targeting youth and families are needed, including counseling patients about the risks of opioids to youth in their families,” the study authors concluded.
To read the study, click here.