Receipt of Prescribed Controlled Substances by Adolescents and Young Adults Prior to Presenting for Opiate Dependence Treatment

Purpose. The objective of this study was to document the number of controlled substance prescriptions filled by adolescents and young adult patients in the 2 years prior to presentation for opiate dependence treatment. Methods. Opiate-dependent youth ( ) presenting to our Medication-Assisted Treatment for Addiction program from January 1, 2008 to June 30, 2010 were identified via electronic medical record. Subjects were further classified based on their opiate use as dependent to heroin-only, prescription (Rx) opiate-only, or combined heroin + Rx opiate only. The Ohio Automated Rx Reporting System (OARRS) was used to identify each subject's controlled substance prescription history. Negative binomial regression was used to examine the relationships between patient characteristics and the total number of prescriptions filled. Results. Twenty-five percent of subjects had filled ≥6 prescriptions, and 15% had filled ≥11 prescriptions. The mean number of prescriptions filled was 5 (range: 0–59). Thirteen percent had filled ≥6 opiate/narcotic prescriptions, and 8% had filled ≥11 prescriptions. Conclusions. A subset of opiate-dependent youth had filled multiple opiate/narcotic prescriptions providing some evidence that physician-provided prescriptions may be a source of opiate abuse or diversion for a minority of opiate-dependent adolescents and young adults. 1. Introduction The nonmedical use of Rx opiates and other controlled drugs by adolescents and young adults has surpassed all illicit drugs except marijuana [1]. A recent report found that, for youth, the peak risk in nonmedical use of prescription pain relievers occurred at the age of 16 years, not during the postsecondary school years as previously suspected [2]. According to the Monitoring the Future Study, the nonmedical use of several prescription medications by 12th graders in the United States is at its highest level in the past 15 years [3]. Concurrently, prescriptions by healthcare providers for controlled substances have also increased. A recent review of over 2.3 million visits by adolescents and young adults found that controlled medications were prescribed for an increasing proportion of adolescent (6.4 versus 11.2%) and young adult visits (8.3 versus 16.1%) between 1994 and 2007, respectively [4]. McCabe et al. found that the estimated prevalence of lifetime medical use of prescription opioids among US high school seniors was 17.6% while the estimated prevalence of lifetime nonmedical use was 12.9% [5]. McCabe has also demonstrated that the prevalence of medical misuse of controlled