Miech R (2015), Pediatrics (Link to abstract)
This is a prospective study investigating the impact of medically prescribed opioids on the risk that adolescents and young adults will misuse opioids in the future. The study found that there was a threefold increase in the rate of misuse in the group of participants who were judged to be at lowest initial risk of opioid misuse (as designated by previous experiences with illegal substances and attitudes toward drug use), and a 33% increase in risk of misuse overall. Interestingly, no independent increase in the risk was identified in the groups stratified to be at higher risk of opioid misuse initially. Recommendations from this study include using non-opioid pain control measures prior to opioids in an effort to minimize their use, and to carefully counsel adolescents who receive opioids around the risks of opioid misuse and abuse.
* Contrary to common teaching, there is actually an increased risk of future opioid misuse in young adults who are appropriately prescribed opioids prior to the end of high school.