Schepis Ty S, Ford Jason A, Veliz Philip T, West Brady T, McCabe Sean Esteban
From the Department of Psychology, Texas State University, San Marcos, TX (TSS); Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, MI (TSS, JAF, PTV, BTW, SEM); Department of Sociology, University of Central Florida, Orlando, FL (JAF); Institute for Social Research, University of Michigan, Ann Arbor, MI (PTV, BTW, SEM); Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI (PTV, SEM); and Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI (PTV, BTW, SEM).
J Addict Med. 2024 Dec 9. doi: 10.1097/ADM.0000000000001428.
Adolescent (12-17 years) and young adult (18-25 years) prescription opioid misuse (POM) is linked to poor health outcomes. We investigated how POM motives vary across these ages and the potential links between motives and other substance use, mental health, and sociodemographic characteristics to help guide screening and prevention.
Pooled 2015-2019 US National Survey on Drug Use and Health data were used, with 137,858 participants. Cross-tabulations estimated prevalence of individual motives and motive category by age. Mutually exclusive motive categories were no past-year POM, pain relief only, pain/sleep/relax (ie, some combination of only these motives), and any non-self-treatment motives (eg, get high, experiment). Logistic regression models evaluated links between motive category and sociodemographic, mental health, and substance use (eg, alcohol, cannabis, nicotine, other prescription misuse) outcomes by age group, versus reference groups of no past-year POM or pain relief only.
Pain relief was the most common POM motive (estimated at >50% at all ages), but POM for non-self-treatment motives was the most common category after 14 years. POM for non-self-treatment motives had the highest adjusted odds ratios (aORs) of all substance use and mental health characteristics (eg, past-year substance use disorder aORs of 6.11 in adolescents [95% confidence interval (CI), 4.23-8.85] and 4.81 [95% CI, 4.01-5.77] in young adults, versus the pain relief only reference).
POM for any non-self-treatment motives is linked to the highest prevalence of other substance use and mental health concerns, whereas POM for pain relief also signals a need for substance use and mental health screening.
青少年（12 - 17岁）和青年（18 - 25岁）的处方阿片类药物滥用（POM）与不良健康后果相关。我们调查了POM动机在这些年龄段中的差异，以及动机与其他物质使用、心理健康和社会人口学特征之间的潜在联系，以帮助指导筛查和预防工作。
使用了2015 - 2019年美国全国药物使用和健康调查的汇总数据，共有137,858名参与者。交叉表按年龄估计了个体动机和动机类别的患病率。相互排斥的动机类别包括过去一年无POM、仅用于止痛、止痛/助眠/放松（即仅这些动机的某种组合）以及任何非自我治疗动机（例如，寻求快感、尝试）。逻辑回归模型按年龄组评估了动机类别与社会人口学、心理健康和物质使用（例如，酒精、大麻、尼古丁、其他处方药物滥用）结果之间的联系，与过去一年无POM或仅用于止痛的参考组进行比较。
止痛是最常见的POM动机（各年龄段估计均超过50%），但14岁后，非自我治疗动机的POM是最常见的类别。在所有物质使用和心理健康特征中，非自我治疗动机的POM调整后的优势比（aORs）最高（例如，青少年过去一年物质使用障碍的aOR为6.11 [95%置信区间（CI），4.23 - 8.85]，青年为4.81 [95% CI，4.01 - 5.77]，与仅用于止痛的参考组相比）。
任何非自我治疗动机的POM与其他物质使用和心理健康问题的最高患病率相关，而用于止痛的POM也表明需要进行物质使用和心理健康筛查。
