Prescription Opioid Abuse and Dependence Increases as Younger Nonmedical Users Grow Older

Researchers compared the findings of 2 surveys—the 1991–1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES) and the 2001–2002 National Epidemiologic Study on Alcohol and Related Conditions (NESARC)—to determine whether increases in nonmedical prescription opioid use, abuse, and dependence were due to increases in all age groups (period effect), increases by age (age effect), or increases by year of birth (cohort effect). Analyses were limited to subjects aged 18–57 divided into 4 age cohorts: 18– 27, 28–37, 38–47, and 48–57.

• There was no change in lifetime nonmedical use of prescription opioids within birth cohorts as they aged, suggesting initiation after age 27 is rare.

• There were significant increases in past-year use and a past-year opioid use disorder (OUD) within most age cohorts, consistent with an age effect.

• Lifetime and past-year prevalence of OUD was highest among more recent birth cohorts, consistent with a cohort effect.

• Lifetime prevalence of OUD increased among almost all pairs of birth cohorts, particularly younger birth cohorts, consistent with a period effect.

Comments:

This study found period, age, and cohort effects have contributed to increases in prescription opioid abuse and dependence. The fact that nonmedical use of prescription opioids is usually initiated by people in their early 20s, becoming more of a problem as these individuals age, suggests we face an even larger problem in the future. Thus, prevention efforts should target youths to prevent the initiation of nonmedical use.

Darius A. Rastegar, MD

Reference:

Martins SS, Keyes KM, Storr CL, et al. Birth-cohort trends in lifetime and past-year prescription opioid-use disorder resulting from nonmedical use: results from two national surveys. J Stud Alcohol Drugs. 2010;71(4):480–487.