Prescription opioid misuse among adolescents and emerging adults in the United States: A scoping review

• Published in: Preventive medicine Vol. 132; p. 105972
• Main Authors: Bonar, Erin E., Coughlin, Lara, Roche, Jessica S., Philyaw-Kotov, Meredith L., Bixler, Emily A., Sinelnikov, Sergey, Kolosh, Alaina, Cihak, Morgan J., Cunningham, Rebecca M., Walton, Maureen A.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-03-2020
• Subjects: Adolescent; Adolescents; Analgesics, Opioid - adverse effects; Drug Overdose - prevention & control; Emerging adults; Humans; Male; Opioid abuse; Opioid misuse; Opioid-Related Disorders; Prescription Drug Misuse - prevention & control; Prescription opioids; Scoping review; United States; Young Adult; United States; Emerging adults; Scoping review; Prescription opioids; Adolescents; Opioid abuse; Opioid misuse
• ISSN: 0091-7435; 1096-0260
• DOI: 10.1016/j.ypmed.2019.105972

The U.S. opioid epidemic is a critical public health problem. As substance use and misuse typically begin in adolescence and emerging adulthood, there is a critical need for prevention efforts for this key developmental period to disrupt opioid misuse trajectories, reducing morbidity and mortality [e.g., overdose, development of opioid use disorders (OUD)]. This article describes the current state of research focusing on prescription opioid misuse (POM) among adolescents and emerging adults (A/EAs) in the U.S. Given the rapidly changing nature of the opioid epidemic, we applied PRISMA Scoping Review (PRISMA-ScR) guidelines to identify empirical articles published in the past 5 years (January 2013–September 2018) from nine databases examining POM among A/EAs (ages 10–25) in the U.S. Seventy-six articles met our inclusion criteria focusing on POM in the following areas: cross-sectional surveys (n = 60), longitudinal cohort studies (n = 5), objective, non-self-reported data sources (n = 9), and interventions (n = 2). Final charted data elements were organized by methodology and sample, with results tables describing design, sample, interventions (where applicable), outcomes, and limitations. Most studies focused on the epidemiology of POM and risk/protective factors, including demographic (e.g., sex, race), individual (e.g., substance use, mental health), and social (e.g., peer substance use) factors. Despite annual national surveys conducted, longitudinal studies examining markers of initiation and escalation of prescription opioid misuse (e.g., repeated overdoses, time to misuse) are lacking. Importantly, few evidence-based prevention or early intervention programs were identified. Future research should examine longitudinal trajectories of POM, as well as adaptation and implementation of promising prevention approaches.
•Most identified studies examined epidemiology of youth prescription opioid misuse.•Few studies explore opioid misuse trajectories or prevention program efficacy.•Future youth prevention research in these two areas is urgently needed.