Mental Health Disorders and Long-term Opioid Use Among Adolescents and Young Adults With Chronic Pain

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• 作者：Laura P. Richardson ; M.D. ; M.P.H.^a ; ^f ; ^{laura.richardson@seattlechildrens.org} ; Joan E. Russo ; Ph.D.^b ; Wayne Katon ; M.D.^b ; Carolyn A. McCarty ; Ph.D.^a ; ^f ; Andrea DeVries ; Ph.D.^e ; Mark J. Edlund ; M.D. ; Ph.D.^c ; Bradley C. Martin ; Pharm.D. ; Ph.D.^d ; Mark Sullivan ; M.D. ; Ph.D.^b
• 关键词：Mental health ; Adolescence ; Prescription drug use ; Chronic pain
• 刊名：Journal of Adolescent Health
• 出版年：2012
• 期刊代码：140_1054139x
• 类别：med
• 出版时间：June, 2012
• 卷：50
• 期：6
• 页码：553-558
• 文件大小：407 K

摘要

Purpose

The purpose of this study was to examine the association between mental health disorders and subsequent risk for long-term opioid use among adolescents and young adults presenting with common chronic pain complaints (back pain, neck pain, headache, and arthritis/joint pain).

Methods

Using claims data from January 1, 2001 to June 30, 2008, we conducted a longitudinal analysis of opioid use patterns among 13-24-year-old subjects presenting with a new episode of chronic pain. Long-term opioid use was defined as receiving >90 days of opioids within a 6-month period with no gap of >30 days in use of opioids in the 18 months after the first qualifying pain diagnosis. Mental health disorders were identified from claims in the 6 months before the first qualifying pain diagnosis.

Results

Fifty-nine thousand seventy-seven youth met criteria for a new episode of chronic pain. Among these youth, 321 (.5%) met criteria for long-term opioid use, and 16,172 (27.4%) had some opioid use. After controlling for demographic and clinical factors, youth with preexisting mental health diagnoses had a 2.4-fold increased risk of subsequently receiving long-term opioids versus no opioids (odds ratio = 2.36, 95%confidence interval = 1.73-3.23) and a 1.8-fold increased likelihood of receiving long-term opioids versus some opioids (odds ratio = 1.83, 95%confidence interval = 1.34-2.50).

Conclusions

Mental health disorders are associated with increased risk for long-term opioid use among adolescents and emerging young adults. Further study is warranted to examine risks and benefits of long-term opioid use in this population.