Associations Between Adolescent Chronic Pain and Prescription Opioid Misuse in Adulthood

JOURNAL OF PAIN

卷:20

Article

Groenewald, Cornelius B.^1,2  Law, Emily F.^1,2  Fisher, Emma⁵  Beals-Erickson, Sarah E.^6,7  Palermo, Tonya M.^1,2,3,4,6,7 

[1] Univ Washington, Sch Med, Dept Anaesthesiol, Seattle, WA 98195 USA

[2] Univ Washington, Sch Med, Dept Pain Med, Seattle, WA 98195 USA

[3] Univ Washington, Sch Med, Pediat, Seattle, WA 98195 USA

[4] Univ Washington, Sch Med, Psychiat, Seattle, WA 98195 USA

[5] Univ Bath, Dept Hlth, Bath, Avon, England

[6] Childrens Mercy Hosp, Div Dev & Behav Sci, Kansas City, MO 64108 USA

[7] Univ Missouri, Kansas City, MO 64110 USA

关键词: Adolescent;    chronic pain;    opioid misuse;   

DOI  :  10.1016/j.jpain.2018.07.007

来源: Elsevier

【 摘 要 】

Prescription opioid misuse is a serious public health concern, yet antecedent factors are poorly described. Using data from the National Longitudinal Study of Adolescent to Adult Health (N = 14,784), we examined the longitudinal relationship between a history of adolescent chronic pain and the odds of misusing prescription opioids in adulthood. The primary predictor variable was chronic pain status during adolescence. The primary outcome variables were prescription opioid misuse during early adulthood and adulthood. Multivariate models controlled for known risk factors of opioid misuse, including sociodemo-graphics (sex, race, and ethnicity), adolescent mental health symptoms (anxiety, depression), adolescent self-reported physical health status, adolescent substance use/abuse, childhood trauma, and adult legitimate opioid use. We found that adults with a history of adolescent chronic pain were more likely to misuse opioids than those without history of chronic pain, even after controlling for other known risk factors. Further, we found that among individuals with history of adolescent chronic pain that race (white), other substance use, and exposure to trauma were risk factors for later opioid misuse. Longitudinal associations between adolescent chronic pain and subsequent adult prescription opioid misuse highlight the need for early targeted screening and prevention efforts that may reduce later opioid misuse. Perspective: Using a large, nationally representative sample, we found that chronic pain during adolescence was an independent risk factor for opioid misuse in adulthood, over and above other known risk factors. Furthermore, among those individuals with adolescent chronic pain, substance use, exposure to trauma, and race were associated with opioid misuse. (C) 2018 by the American Pain Society

【 授权许可】

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