Trends in Personal and Family Member Opioid Prescriptions Prior to a Diagnosis of an Opioid-Related Problem among Adolescents and Young Adults

Abstract

Background Efforts to reduce the risk of opioid misuse are often focused on reducing unnecessary prescriptions for opioid medications or reducing the dose prescribed; however, not all misuse occurs in individuals with a personal prescription. This study examined trends in the proportion of adolescents and young adults (AYAs) who had an opioid-related problem (ORP) and who also had a personal opioid prescription drug claim or had a family member with an opioid prescription drug claim prior to the ORP diagnosis. Methods A retrospective cohort design was used to analyze longitudinal claims data. We identified individuals aged 12 to 25 years who had a newly diagnosed ORP in the years 2006 to 2014. Trends over time in personal or family opioid prescription drug claims within 1 year prior to ORP diagnosis were examined. Results We identified 53,560 AYAs with an ORP diagnosis. Over the entire study period, 40% of AYAs with an ORP diagnosis had a personal opioid prescription in the year prior to diagnosis, and 48% had a family member with an opioid prescription in the prior year. While the proportion of AYAs with a family prescription remained constant, the proportion with a personal prescription fell from 77.1% in 2006 to 27.3% in 2014. Conclusions The number of AYAs with an ORP increased over time, yet the proportion with a personal opioid prescription claim prior to their diagnosis decreased over time. This suggests that providers are paying greater attention to prescribing opioids to AYAs directly, although prescriptions to family members may still remain a point of access.

Association of Household Opioid Availability With Opioid Overdose

“…These results suggest that a recent opioid fill to a household member is associated with greater odds of opioid overdose, even after accounting for demographic characteristics, comorbidities, and personal fills of opioids and benzodiazepines. Findings from this study are consistent with a growing literature suggesting that household opioid availability is associated with increased odds of opioid-related adverse effects in household members …”

“…Findings from this study are consistent with a growing literature suggesting that household opioid availability is associated with increased odds of opioid-related adverse effects in household members. 10,11,[23][24][25][26][27] While most studies to date have focused on adolescents or young adults in family units who share the same insurance policy number, 10,11,23,28 our study focused on adults who live at the same address and may not be on the same insurance policy or have familial ties. Using this broader definition of household, our findings are similar to those of previous studies reporting that opioid prescriptions to family members significantly increased youth overdose risk.…”

Association between household opioid prescriptions and risk for overdose among family members not prescribed opioids

“…12,13 For example, researchers found an increased rate of opioid overdose among adolescents and young adults who had family members with an opioid prescription, 14 and similar results have been reported elsewhere. 15,16 In this article, we conduct a population-based cohort study of enrollees with commercial health insurance to examine the association between opioid-related overdose/poisoning and opioids in the household among family members who were not prescribed an opioid. We analyze effects across the age spectrum and specifically focus on adverse events among infants and toddlers; the age groups most likely to experience an accidental overdose or poisoning.…”

Association of Postsurgical Opioid Refills for Patients With Risk of Opioid Misuse and Chronic Opioid Use Among Family Members

“…22 In recent years, there have been attempts to measure the harmful downstream consequences of household opioid exposure. [23][24][25][26][27][28] One large retrospective study of claims data found that, among those with opioid use disorder without their own prescription, 51% had access to opioids through a household member's prescription. 29 Another study found that prescription opioid use by a patient in the household increased another member's absolute risk of starting prescription opioids by 0.7%.…”

“…In recent years, there have been attempts to measure the harmful downstream consequences of household opioid exposure . One large retrospective study of claims data found that, among those with opioid use disorder without their own prescription, 51% had access to opioids through a household member’s prescription .…”