Young Adult Healthcare Exposure and Future Opioid Misuse: A Prospective Cohort Study

Citation

Fergus, K. B.; Schwab, M. E.; Butler, C.; Cattle, C. J.; Breyer, B. N.; Copp, H. L.; & Nagata, J. M. (2022). Young Adult Healthcare Exposure and Future Opioid Misuse: A Prospective Cohort Study. Am J Prev Med. , PMCID: PMC10012501

Abstract

INTRODUCTION: Outpatient opioid prescribing is associated with opioid misuse in young adults, but the longitudinal association between general healthcare exposure and opioid misuse has not been explored. The objective of this study is to examine the association between healthcare exposure in young adulthood and future opioid misuse. METHODS: Data were drawn from the National Longitudinal Study of Adolescent to Adult Health (2001-2018) and analyzed in 2021. Healthcare exposure (i.e., inpatient hospitalization and visits to the clinic, emergency department, mental-health facility, or dentist) between individuals aged 18 and 26 years was the primary independent variable; only patients who did not report opioid misuse at baseline were included. Opioid misuse was defined as using prescription painkillers without a doctor's permission and was measured 17 years after exposure. Multivariable logistic regression was used to examine any associations with opioid misuse (ages 33-43 years). RESULTS: A total of 8,225 young adults with a mean baseline age of 21.8 (SE=0.12) years met inclusion criteria. Approximately 13.7% reported new opioid misuse at follow-up. Those reporting opioid misuse at follow-up were more likely to be White, lack a college education, or report depression. Those exposed to inpatient hospitalization, emergency departments, or mental-health facilities had an increased risk of future opioid misuse. CONCLUSIONS: In young adults reporting no opioid misuse at baseline, healthcare exposure was associated with an increased risk of opioid misuse later in adulthood in this large, national cohort. Physicians encounter this at-risk population daily, reinforcing the importance of responsible prescribing practices and the need for targeted screening, patient education, and intervention efforts in the healthcare setting.

URL

https://doi.org/10.1016/j.amepre.2021.12.026

Keyword(s)

Wave III

Notes

1873-2607

Reference Type

Journal Article

Journal Title

Am J Prev Med

Author(s)

Fergus, K. B.
Schwab, M. E.
Butler, C.
Cattle, C. J.
Breyer, B. N.
Copp, H. L.
Nagata, J. M.

Year Published

2022

Edition

March 14, 2022

DOI

10.1016/j.amepre.2021.12.026

PMCID

PMC10012501

Reference ID

9656