Risk for opioid abuse and misuse in adolescence

青春期滥用和误用阿片类药物的风险 摘要 目前处方阿片类药物滥用的比率在成年人中上升到流行水平。这些费率可能是 在青少年中甚至更高，他们在此期间有更高的物质探索和滥用水平 精确的发育期。通过合法处方接触阿片类药物的青少年 高中毕业后滥用的风险增加。然而，我们对什么有很大的了解差距 在这些高危青年中，一些因素可能导致滥用和相关不良结局的发展。 确定增加阿片类药物使用和有问题的使用的风险的因素将告知青少年 阿片类药物滥用的模式，并为制定预防干预措施提供信息，以改变医疗风险 布景。青少年通过合法处方接触阿片类药物的儿科医疗环境是 进入阿片类药物使用的独特切入点，以及检查青少年结果的关键环境。这个 拟议的研究将利用通过合法处方接触阿片类药物的影响的发展模型 在青春期后期，考虑到疼痛和个体内部的心理特征 家庭和同辈的背景。阿片类药物使用增加和问题使用的预测因素和机制将是 在青春期后期的两年时间内进行检查。中心假设是青春期的疼痛 随着时间的推移，特征将影响阿片类药物的使用和问题，而阿片类药物的可获得性将调节这一点 协会。疼痛药物特定的父母因素也将被检查，包括父母慢性疼痛和 阿片类药物处方，对止痛药的态度，以及疼痛灾难。阿片类药物的纵向模型 将在接受非阿片类药物处方的14-18岁青少年样本中测试使用和阿片类药物问题 门诊医疗环境中的癌症疼痛(n=500名青少年和一名家长将参加)。这些 青少年将在两年内每6个月接受一次评估，并将报告疼痛特征、阿片类药物和 其他物质使用和问题、同伴因素以及疼痛灾难和其他与疼痛有关的因素 心理因素。目的从处方药中获得有关分配阿片类药物的数据 监控数据库。青春期疼痛、疼痛灾难和阿片类药物使用意愿之间的日常联系 也要接受检查。在这一发展转型期间确定风险的机制和调节因素将 为旨在减少高危人群阿片类药物使用障碍的干预措施的设计提供关键信息 青春年华。

Risk for Opioid Abuse and Misuse in Adolescence Abstract Current rates of prescription opioid misuse are rising to epidemic levels among adults. These rates may be even higher among adolescents, who have elevated levels of substance exploration and misuse during this precise developmental period. Adolescents who are exposed to opioids via legitimate prescriptions are at increased risk for misuse after high school. However, there is a substantial gap in our knowledge of what factors might contribute to the development of misuse and related poor outcomes in these high-risk youth. Identifying factors that convey risk for increasing opioid use and problematic use would inform adolescent models of opioid abuse and inform the development of preventive interventions to modify risk in the medical setting. The pediatric medical setting, where adolescents are exposed to opioids via legitimate prescription is a unique point of entry into opioid use, and a key setting in which to examine adolescent outcomes. The proposed study will utilize a developmental model of the impact of opioid exposure by legitimate prescription during late adolescence, with consideration for pain and psychological characteristics of the individual within the family and peer context. Predictors and mechanisms of increasing opioid use and problematic use will be examined over a 2 year time period during late adolescence. The central hypothesis is that adolescent pain characteristics will influence opioid use and problems over time, and that opioid availability will mediate this association. Pain medication specific parent factors will also be examined, including parental chronic pain and opioid prescriptions, attitudes about pain medications, and pain catastrophizing. Longitudinal models of opioid use and opioid problems will be tested in a sample of 14-18 year olds receiving opioid prescriptions for non- cancer pain in outpatient medical settings (n= 500 adolescents and a parent will be enrolled). These adolescents will be assessed every 6 months for 2 years, and will report on pain characteristics, opioid and other substance use and problems, peer factors, as well as pain catastrophizing and other pain-related psychological factors. Objective data on dispensed opioid medications will be obtained from prescription drug monitoring databases. Daily associations between adolescent pain, pain catastrophizing, and opioid use will also be examined. Determining mechanisms and moderators of risk during this developmental transition will provide critical information for the design of interventions aimed at reducing opioid use disorders in at-risk youth.