Highlights
- •Adolescent chronic pain was associated with future opioid misuse.
- •Trauma exposure and substance use increased opioid misuse risk among those with pain.
- •Depressive and anxiety symptoms were not associated with opioid misuse.
Abstract
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 sociodemographics (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.
Key words
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Article info
Publication history
Published online: August 08, 2018
Accepted:
July 14,
2018
Received in revised form:
July 11,
2018
Received:
February 12,
2018
Footnotes
Supported by an early career grant from the International Association for the Study of Pain (PI: C.B.G.) and the National Institutes of Health (grant nos. K24HD060068 [PI: T.M.P.] and K23NS089966 [PI: E.F.L.])
The authors have no conflicts of interest to declare.
Identification
Copyright
© 2018 by the American Pain Society
