Doctors Should Prescribe Least Opioids Necessary To Young Adults, Children: Study

Teens are just as likely to overdose on opioids as adults, according to the findings of a new study highlighting the risks associated with prescribing more of the narcotic painkillers than necessary.

A new study by University of Michigan researchers indicates that despite the difference in age, teens face the same risk of overdose from prescribed drugs like Norco or OxyContin, especially when given long acting or extended release formulas. The findings were published on December 16, in the journal JAMA Pediatrics.

Opioids like Vicodin account for 70% of all overdose deaths in the U.S. They are often prescribed by doctors without a documented pain diagnosis or reason. One in eight teens and young adults are prescribed opioids every year.

Researchers conducted a study of 2.7 million teens and young adults ages 12 to 21, who had daily opioid use and concurrent benzodiazepine use. Opioid prescription claims data came from the IBM MarketScan Commercial Claims and Encounters database from July 2009 to October 2017.

According to the findings, each increase in daily opioid dosage was associated with a higher overdose risk for teens. The study indicates one in 10,000 teens and young adults overdosed on opioids, which is the same overdose rate as adults who have undergone surgery within the past 30 days.

Roughly 30% of opioid overdoses analyzed during the study involved prescription opioids given to a teen by their doctor.

The risk for teens is even higher if they also used benzodiazepines, like Xanax and Valium. Compared with no use, both concurrent benzodiazepine use and extended release or long acting opioid formulas were linked to increased overdose risk.

Benzodiazepines are class of drug that affect the central nervous system and depresses it.  They are often prescribed for anxiety, stress, panic attacks, and sleep disorders. Common benzos are Xanax and Valium. Young adults 18 to 29 have the highest rates of benzodiazepine misuse in the U.S. The FDA called for a black box warning in 2016, indicating using opioids and benzodiazepines together increased the risk of serious health side effects, including death.

Researchers also found the opioid overdose risk for teens was three times higher if they had a mental health or substance use disorder. According to their findings, half of overdoses involved teens with a recent mental health diagnosis and one-quarter involved patients with substance use disorders.

Researchers recommend doctors use the lowest effective dosage of opioids and avoid concurrent opioid and benzodiazepine use to help reduce the risk to teens and young adults. They determined doctors should focus on using short acting opioids and consider prescribing naloxone, the overdose reversal drug, when prescribing opioids to help prevent potential overdoses.