Objectives Most US studies of national trends in medical and nonmedical use of prescription opioids have focused on adults. Given this gap in understanding these trends among adolescents, we examine national trends in the medical and nonmedical use of prescription opioids among high school seniors between 1976 and 2015. Methods The data used for the study comes from the Monitoring the Future study of adolescents. Forty cohorts of nationally representative samples of high school seniors (modal age 18) were used to examine self-reported medical and nonmedical use of prescription opioids. Results Lifetime prevalence of medical use of prescription opioids peaked in both 1989 and in 2002, and remained stable until a recent decline from 2013 through 2015. Lifetime nonmedical use of prescription opioids was less prevalent and highly correlated with medical use of prescription opioids over this forty-year period. Adolescents who reported both medical and nonmedical use of prescription opioids tended to be more likely to indicate medical use of prescription opioids prior to initiating nonmedical use. Conclusions Prescription opioid exposure is common among US adolescents: long-term trends indicate that one-fourth of high school seniors self-reported medical or nonmedical use of prescription opioids. Medical and nonmedical use of prescription opioids has declined recently and remained highly correlated over the past four decades. Sociodemographic differences and risky patterns involving medical and nonmedical use of prescription opioids should be taken into consideration in clinical practice to improve opioid analgesic prescribing and reduce adverse consequences associated with prescription opioid use among adolescents.

Purpose There is a need to obtain greater clarity regarding adolescents’ e-cigarette use and their use with a wider range of risk behaviors. This study examines the associations among past-month e-cigarette use only, traditional cigarette smoking only, dual use (i.e., concurrent e-cigarette use and cigarette smoking), school-related (i.e., truancy and poor academic performance), and substance-related (i.e., alcohol use, binge drinking, marijuana use, illicit drug use, and nonmedical prescription drug use) risk behaviors. Methods Data were collected via self-administered questionnaires from a nationally representative sample of 8,696 high school seniors. Results An estimated 9.9% of U.S. high school seniors reported past-month e-cigarette use only, 6.0% reported past-month cigarette smoking only, and 7.3% reported past-month dual use. School-related and substance-related risk behaviors had strong associations with past-month e-cigarette use. Adolescents who only used e-cigarettes had significantly greater odds of all school-related and substance-related risk behaviors relative to non-users. Dual users had significantly greater odds of frequent/daily e-cigarette use as well as all school-related and substance-related risk behaviors relative to those who only used e-cigarettes. Finally, adolescents who engaged in frequent/daily e-cigarette use had significantly greater odds of binge drinking, marijuana use, other illicit drug use and nonmedical prescription drug use, relative to experimental e-cigarette users. Conclusion E-cigarette use is common among U.S. adolescents and there are robust associations between e-cigarette use and school-related and substance-related risk behaviors. There is evidence that e-cigarette use clusters with risk behaviors and appears to represent a problem behavior, especially dual use of e-cigarettes and traditional cigarettes.

Little is known about the prevalence and correlates of concussions among US adolescents. A regional study of Canadian adolescents found that approximately 20% had sustained a concussion. 1,2 Providing a national baseline of concussion prevalence and correlates is necessary to target and monitor prevention efforts to reduce these types of injuries during this important developmental period.

Background The empirical research examining the impact of sports participation on alcohol and other drug use has produced mixed results. Part of this problem may be the result of how different types of sports participation create different experiences that shape certain types of behaviors that either facilitate or deter substance use. Objectives We examined the association between different types of competitive sports participation and substance use among a nationally representative sample of adolescents. Methods Two recent cross-sections from the Monitoring the Future were merged to capture a large subsection of adolescents who participate in either high-contact sports (football, wrestling, hockey and lacrosse), semi-contact sports (baseball, basketball, field hockey and soccer), and non-contact sports (cross-country, gymnastics, swimming, tennis, track, and volleyball). Results Multivariate analyses revealed that adolescents who participated in high-contact sports had higher odds of using substances during the past 30 days and initiating substance use at early ages. Further, adolescents who participated in non-contact sports had lower odds to indicate smoking cigarettes and marijuana during the past 30 days. Conclusions Parents, educators, and policy makers need to consider that some sporting contexts may be a catalyst to engage in risky behaviors like substance use.

The objective of this study was to examine the association of context of prescription opioid exposure (i.e., medical and/or nonmedical) in adolescence with the subsequent risk of nonmedical use of prescription opioids (NMUPO) and substance use disorder (SUD) symptoms at age 35. Multiple cohorts of nationally representative probability samples of U.S. high school seniors (n = 4072) were surveyed via self-administered questionnaires and followed longitudinally from adolescence (modal age 18, graduating classes 1976–1996) to age 35 (1993–2013). Main outcome measures were past-year NMUPO and SUD symptoms. The medical and nonmedical use of prescription opioids during adolescence was significantly associated with NMUPO at age 35. Relative to no prescription opioid exposure, medical use of prescription opioids without any history of NMUPO during adolescence was not associated with SUD symptoms at age 35. In contrast, compared with no prescription opioid exposure during adolescence, the adjusted odds ratios (AORs) associated with SUD symptoms at age 35 were greater among those with a history of both medical use of prescription opioids and NMUPO during adolescence, AOR = 1.49 (95% confidence interval [CI], 1.13–1.97); and among those who reported NMUPO only, AOR = 2.61 (95% CI, 1.88–3.61). The findings indicate medical use of prescription opioids without any history of NMUPO in adolescence is not associated with SUD symptoms at age 35 while any NMUPO in adolescence predicts SUD symptoms at age 35. Screening instruments and preventative intervention programs to reduce NMUPO and SUDs must account for the context associated with prescription opioid exposure during adolescence.

These findings provide valuable new information about sexual minority subgroups, such as self-identified bisexual older adults and sexual identity-attraction discordant women, that appear to be at higher risk for adverse smoking-related health consequences as a result of their elevated rates of cigarette smoking. Additional attention is warranted to examine these high-risk subpopulations prospectively and, if the results are replicated with larger samples, this information can be used to target smoking-cessation and lung cancer screening efforts.

Background: This longitudinal study assesses characteristics associated with adolescents’ nonmedical use of prescription opioids (NMUPO) including: frequency, co-ingestion, motives, specific opioid type; sequence of initiation of medical use of prescription opioids and NMUPO in relationship to subsequent substance use disorder (SUD) symptoms. Methods: Twenty-one independent national cohorts of U.S. high school seniors (n = 8,373) were surveyed and followed 17 years from adolescence to age 35. Results: The majority of adolescents who engaged in NMUPO reported occasional/frequent NMUPO, non-pain relief motives for NMUPO, simultaneous co-ingestion involving NMUPO and other drugs, opioid analgesics with high misuse potential, and multiple types of opioid analgesics. Adolescents who reported NMUPO for pain relief, NMUPO involving opioid analgesics with high misuse potential, or multiple prescription opioids had significantly greater odds of symptoms of SUD symptoms at age 35, relative to those who had no history of NMUPO during adolescence. In addition, medical use of prescription opioids after initiating NMUPO (or NMUPO only) during adolescence was associated with significantly greater odds of subsequent SUD symptoms at age 35 relative to those who reported the medical use of prescription opioids only or had no medical use or NMUPO during adolescence. Conclusions: This is the first U.S. national prospective study to examine the relationships between adolescents’ NMUPO characteristics and later SUD symptoms in early midlife. Several characteristics (frequency, co-ingestion, motives, opioid type, and medical/NMUPO initiation history) were identified that could be used to screen and detect high-risk youth for indicated interventions to reduce prescription opioid misuse and SUDs.

Purpose The objective of this longitudinal study was to assess the prevalence of medical use, medical misuse, and nonmedical use of opioid medication among adolescents who participate in organized sports. Methods Data for this study were taken from the Secondary Student Life Survey (SSLS). A total of 1,540 adolescents participated in three waves of data collection occurring between the 2009–10 and 2011–12 school years, with 82% of the baseline sample completing all three waves. Results Using Generalized Estimating Equation (GEE) models to analyze the longitudinal data, it was found that male adolescents who participated in organized sports during each wave of the SSLS had higher odds of being prescribed an opioid medication (i.e., medical use) during the past year (AOR = 1.86, 95% CI = 1.23, 2.82), higher odds of past-year medical misuse of opioid medication due to taking too much (AOR = 10.5, 95% CI = 2.42, 45.5), and higher odds of past-year medical misuse of opioid medication in order to get high (AOR = 4.01, 95% CI = 1.13, 14.2) when compared to males who did not participate in organized sports during the study period. Among females, no association was found between participation in organized sports and medical use, medical misuse, and nonmedical use of opioid medication. Conclusions The results of this study indicate that adolescent males who participate in sports may have greater access to opioid medication, putting them at greater risk to misuse these controlled substances.