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Cited by 17Opioid Use Disorder TreatmentSubstance Abuse Treatment and OutcomesPain Management and Opioid Use

Contextual risk among adolescents receiving opioid prescriptions for acute pain in pediatric ambulatory care settings

Open access
Dash, Genevieve F., Feldstein Ewing, Sarah W., Murphy, Corrin, Hudson, Karen A., Wilson, Anna C.·2020·Addictive Behaviors
DOI 10.1016/j.addbeh.2020.106314PMC PMC7024039
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Abstract

Many adults with opioid use disorder (OUD) report that their first exposure to opioids was in the course of routine pain treatment in medical care settings. Adolescents receive opioid prescriptions with frequency, but are susceptible to a constellation of unique risks in the context of pain management. This empirical study presents the first cohort of adolescents recruited from ambulatory medical care within 72 h of their receipt of opioids to treat acute pain. The primary aim was to capture a time-sensitive report of the intersection of prescription opioid receipt and contextual risks for opioid misuse related to pain experience, mental health symptoms, and substance use at the adolescent and parental levels. Data were collected from 70 14-19-year-old adolescents and their accompanying parent. Results reflected that 90% of this sample of adolescents reported 2 or more risks and 35% reported 5 or more risks for future opioid misuse. Pain catastrophizing (46%) and alcohol use (40%) and were the most common adolescent-level risk factors; mother history of chronic pain (32%) and parent anxiety (21%) were the most common parent-level risk factors. Past-week parent pain intensity showed the strongest association with adolescent past-week pain intensity; neither was associated with adolescent OUD symptoms. Adolescent pain catastrophizing most reliably predicted OUD symptoms; parent pain interference was also associated. Seventy-one percent of parents reported keeping opioids at home, a relevant risk factor for future misuse. These findings illuminate the intersection between adolescent and parental risks in the context of pediatric opioid prescribing for acute pain management, and provide initial insight into potential points of prevention early in adolescent pain treatment, including avenues by which to inform and enhance prescriber decision-making regarding factors to be weighed in adolescent candidacy for opioid therapy.

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  • Adolescents with a disease who need routine medical pain treatment have a higher risk of opioid misuse.

    “The paper by Dash et al. (2020) highlight adolescent with a disease who needs routine medical pain treatment have higher risk of opioid misuse [38].”

    From Risk and protective factors of drug abuse among adolescents: a systematic review (2021) · cites this paper as [38]

    The Introduction says that opioid use during adolescence, even when prescribed for pain, is associated with later opioid misuse. But the study concerns adolescents prescribed opioids for acute pain in ambulatory care; it does not establish the claim specifically for adolescents with a disease who need routine pain treatment. The Abstract reports risk factors in that acute-pain cohort, not a comparison showing that the claimed group has higher risk. (LLM, conf=0.85)

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  • Strong religious beliefs integrated into society serve as a crucial protective factor that can prevent adolescents from engaging in drug abuse.

    “Strong religious beliefs integrated into society serve as a crucial protective factor that can prevent adolescents from engaging in drug abuse [38, 45].”

    From Risk and protective factors of drug abuse among adolescents: a systematic review (2021) · cites this paper as [38]

    The Introduction describes values against alcohol and drug use as a barrier to adolescent substance use, and the Parent-Level Risk Factors section says parental attitudes can shape adolescents’ perceptions of substance-use risk. Neither passage identifies religious beliefs or beliefs integrated into society as a protective factor, or establishes that they prevent drug abuse. (LLM, conf=0.78)

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Authors
Dash, G. F., Feldstein Ewing, S. W., Murphy, C., Hudson, K. A., & Wilson, A. C.
Affiliations
  • University of Missouri (US)
  • Oregon Health & Science University (US)
Corresponding author
Dash, Genevieve F.
ORCID
Venue
Addictive Behaviors
Publisher
Elsevier BV
Published
2020-05
Volume
104
Pages
106314
ISSN
0306-4603 (ISSN-L)
DOI
10.1016/j.addbeh.2020.106314
PMC
PMC7024039
OpenAlex
W3000195453
Cited by
17
References
75
Citations by year
2026: 5 · 2025: 5 · 2024: 2 · 2023: 1 · 2022: 2 · 2021: 1 · 2020: 1
FWCI
0.94
Type
journal article
Language
en
Open access
Licence
Locations
  • Addictive Behaviors (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute on Alcohol Abuse and Alcoholism
  • National Center for Advancing Translational Sciences
  • National Institute on Drug Abuse
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Keywords
opioid misuse, adolescents, acute pain management, opioid prescribing, contextual risk factors, opioid use disorder, pain catastrophizing, parental anxiety, alcohol consumption, pediatric outpatient care, prevention
MeSH terms
Adolescent, Ambulatory Care, Analgesics, Opioid, Family Characteristics, Female, Humans, Male, Opioid-Related Disorders, Parents, Risk Factors, Prescription Drugs, Young Adult, Acute Pain, Prescription Drug Misuse

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