Risk for opioid abuse and misuse in adolescence

青少年滥用阿片类药物的风险 摘要 目前处方阿片类药物滥用率正在上升到成年人中的流行水平。这些利率可能是 在青少年中甚至更高，他们在此期间的物质探索和滥用水平升高 准确的发展时期。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，我们对什么的认识存在很大的差距。 这些因素可能会导致这些高危青少年滥用药物和相关不良后果的发展。 确定增加阿片类药物使用和有问题使用风险的因素将告知青少年 阿片类药物滥用模型，并为制定预防性干预措施提供信息， 设置.在儿科医疗环境中，青少年通过合法处方接触阿片类药物是一种 阿片类药物使用的独特切入点，以及审查青少年结果的关键环境。的 拟议的研究将利用合法处方阿片类药物暴露影响的发展模型 在青春期后期，考虑到个人的疼痛和心理特征， 家庭和同伴环境。阿片类药物使用和问题使用增加的预测因素和机制将在 在青春期后期的2年时间内进行检查。核心假设是青少年的疼痛 特征将影响阿片类药物的使用和问题，随着时间的推移，阿片类药物的可用性将介导这一点， 协会还将检查疼痛药物特异性父母因素，包括父母慢性疼痛和 阿片类药物处方，对止痛药的态度，以及疼痛灾难化。阿片类药物的纵向模型 使用和阿片类药物问题将在14-18奥尔兹接受阿片类药物处方的非阿片类药物患者中进行测试， 门诊医疗环境中的癌症疼痛（将入组n= 500名青少年和一名父母）。这些 青少年将每6个月进行一次评估，持续2年，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，以及疼痛灾难化和其他疼痛相关 心理因素将从处方药中获得关于分发的阿片类药物的客观数据 监控数据库。青少年疼痛，疼痛灾难化和阿片类药物使用之间的日常联系将 也要检查。在这一发展转型过程中，确定风险的机制和调节因素将 为设计旨在减少高危人群阿片类药物使用障碍的干预措施提供关键信息 青年

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.