Longitudinal trajectories of prescription opioid misuse in adolescents

Lorraine I Kelley-Quon; Junhan Cho; Jessica Barrington-Trimis; Michele D Kipke; John D Clapp; Evan A Krueger; Adam M Leventhal

doi:10.1016/j.drugalcdep.2022.109470

Longitudinal trajectories of prescription opioid misuse in adolescents

Drug Alcohol Depend. 2022 Jul 1:236:109470. doi: 10.1016/j.drugalcdep.2022.109470. Epub 2022 Apr 22.

Authors

Lorraine I Kelley-Quon¹, Junhan Cho², Jessica Barrington-Trimis², Michele D Kipke³, John D Clapp⁴, Evan A Krueger², Adam M Leventhal²

Affiliations

¹ Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA; Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA; Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA. Electronic address: lkquon@chla.usc.edu.
² Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA.
³ Division of Research on Children, Youth and Families, The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, CA, USA.
⁴ Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA.

Abstract

Background: Adolescent misuse of prescription opioids is hazardous. This study aimed to generate data on prescription opioid misuse trajectories across adolescence and identify risk factors and mechanisms for more dangerous use trajectories.

Methods: Using a prospective longitudinal cohort repeated measures design, baseline (Fall 2013) and seven semiannual assessments were administered through Spring 2017 in 10 public high schools in Los Angeles, CA. Frequency of past 30-day prescription opioid misuse was captured. Trajectory groups were identified using growth mixture modeling and multinomial logistic regression identified associations between baseline risk factors with membership in each trajectory group.

Results: Overall, 3395 students were evaluated (53.4% female, Mean [SD] age at baseline=14.58[0.40]; range=12.83-16.29). Four discrete misuse trajectories were identified among 1062 students: (1) Minimal/Experimental (infrequent time-limited use; range of estimated mean number of days using prescription opioid across waves=0.0-0.6 days]; N = 705[20.8%]); (2) Low Deescalating (range=2.0-0.7 days; N = 189[5.6%]); (3) Moderate Escalating (range=0.7-3.6 days; N = 108[3.2%]); and (4) Frequent Persistent (range=4.7-9.4 days; N = 60[1.8%]). Students reporting tobacco, cannabis, alcohol use, or impulsivity in 9th grade were more likely to demonstrate membership in the Moderate Escalating trajectory class when compared to 2333 (68.7%) students reporting sustained abstinence. Female sex, peer opioid misuse, alcohol use, other substance use, impulsivity, or delinquent behavior reported in 9th grade was associated with membership in the Frequent Persistent trajectory class.

Conclusions: Prescription opioid misuse in adolescence appears to follow 4 discrete trajectories, including the potentially problematic Moderate Escalating and Frequent Persistent trajectories. Female sex, peer influences, substance use, and intrapersonal risk factors were associated with membership in these classes.

Keywords: Misuse; Prescription opioid; Prospective cohort; Trajectory.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Adolescent
Alcohol Drinking
Analgesics, Opioid / therapeutic use
Female
Humans
Male
Opioid-Related Disorders* / drug therapy
Prescription Drug Misuse*
Prospective Studies
Students

Substances

Analgesics, Opioid

Abstract

Publication types

MeSH terms

Substances

Grants and funding