U.S. teens and young adults are as likely as older people to overdose on prescription opioid painkillers and have the same risk factors, researchers say.
They analyzed data on 2.8 million privately insured patients from 12 to 21 years of age who received opioid prescriptions between 2009 and 2017.
One in 10,000 had an opioid overdose, the same rate as among adult patients within 30 days of surgery. Having a substance use or mental health disorder tripled the risk of overdose among teens and young adults.
Half of the overdoses occurred among youths recently diagnosed with a mental health condition and a quarter involved patients with a substance use disorder, according to the study published Dec. 16 in the journal JAMA Pediatrics.
It also found that the risk of overdose was higher when teens and young adults took high daily doses of opioids, took long-acting opioids such as OxyContin, and took opioids at the same time as benzodiazepines (such as Xanax, Valium, Klonopin), which are central nervous system depressants for anxiety, stress attacks and sleep disorders.
"Our knowledge of risk factors for prescription opioid overdose comes mostly from studies of middle-aged and elderly patients, particularly U.S. veterans. There is little data about risk factors for overdose specifically in adolescents and young adults," said study lead author Dr. Kao-Ping Chua, a pediatrician and researcher at Michigan Medicine's C.S. Mott Children's Hospital in Ann Arbor.
"Our findings suggest that clinicians can mitigate overdose risk in adolescents and young adults by using the lowest amount of opioid possible, relying on short-acting opioids, and avoiding the concurrent use of opioids and benzodiazepines," Chua said in a hospital news release.
Previous research suggests that about 1 in 8 U.S. teens and young adults are prescribed opioids each year. About 30% of the 3,000 opioid overdose deaths in this population during 2016 involved prescription opioids.
"These numbers highlight the importance of mitigating overdose risk when prescribing opioids to adolescents and young adults," Chua said.
Researchers said their findings can help guide doctors when they're prescribing opioids to young people, and may also assist in developing national guidelines.
"The safest approach may be to initiate opioid therapy using a short-acting opioid and the lowest potentially effective daily dosage," Chua said. "If needed, dosage can be slowly and carefully increased."
The U.S. National Library of Medicine has more on safe opioid use.