Narcotic Painkiller Use in Adolescence May Raise Risk of Adult Addiction
Study found those less experienced with illegal drugs were more likely to abuse narcotics later
By Steven Reinberg
WEDNESDAY, Oct. 28, 2015 (HealthDay News) -- Teens who are given prescription narcotic painkillers may run a higher risk of abusing narcotics after high school, a new study suggests.
Researchers said teen painkiller use was associated with a 33 percent increased risk of later abuse. And it was seen mostly among those with little to no history of drug use and those who strongly disapproved of illegal drug use.
"A prescription for a pain reliever can put adolescents at risk for future pain reliever misuse," said study author Richard Miech, a research professor at the Survey Research Center at the University of Michigan in Ann Arbor.
For the study, Miech and his colleagues used data that tracked more than 6,200 high school seniors until they were 23.
At first glance, it seems counterintuitive that the increased risk was concentrated among teens who had little experience with illegal drugs, Miech acknowledged.
"This finding may be explained in part by the novelty of drug use effects," he said. For teens with little to no drug history, a prescription narcotic painkiller is likely to be their first experience with an addictive substance, Miech explained.
"Most likely, the initial experience of pain relief is pleasurable and a safe initial experience may reduce perceived danger," he said. "A pleasurable and safe initial experience with a drug is a central factor in theories of who goes on to misuse drugs."
In contrast, among teens with more extensive experience with drugs, the legitimate use of a narcotic pain reliever may make relatively less of an impression in comparison to the other drugs they have used, Miech said.
"Although these experienced individuals may go on to misuse prescription pain relievers, such misuse does not appear to result from an introduction to pain relievers through a legitimate prescription," he said.
The findings are especially timely in light of the recent decision by the U.S. Food and Drug Administration to approve the use of the narcotic painkiller OxyContin for children ages 11 to 16, he said.
"These findings suggest a currently unrecognized risk of narcotic prescribing," Miech said. "This risk should be incorporated into prescribing decisions and patient counseling."
However, the study did not prove that prescription narcotic painkiller use in adolescence causes adult addiction to narcotics.
Doctors and parents informed of these risks may opt for non-narcotic medications as the initial treatment for minor painful conditions, Miech said.
The report was published online Oct. 26 in the journal Pediatrics.
Dr. Craig Spurdle, a pediatric orthopedic surgeon at Nicklaus Children's Hospital in Miami, said narcotic painkillers should only be used to treat serious pain from trauma, cancer or other surgery, and then only for a short time.
After major surgery, Spurdle prescribes a narcotic painkiller, but only for three to five days.
For other patients, for example, one who has chronic back pain, narcotics are not the best medicine, he said.
"If that patient is getting narcotics, I think that's a mistake," said Spurdle, who was not involved with the new research. "Those patients should be in physical therapy, a fitness program, a wellness program, and they should take non-narcotic pain medicines."
Giving narcotics to those patients is unnecessary and can cause unwanted side effects such as constipation, depression and lethargy, Spurdle said.
"There are very good solutions to some of these problems that are a lot healthier and have a lot better outcomes for the patient," he said. "In those patients, giving narcotics is really a path to the dark side."
Visit the U.S. National Library of Medicine for more on pain medications.
SOURCES: Richard Miech, Ph.D., research professor, Survey Research Center, University of Michigan, Ann Arbor; Craig Spurdle, M.D., pediatric orthopedic surgeon, Nicklaus Children's Hospital, Miami, Fla.; Oct. 26, 2015, Pediatrics, online
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