Abstract
Background
Non-medical prescription-opioid (NMPO) use has been declared a national epidemic in the US. Opioid misuse is associated with substantial physiological, psychological, and concomitant economic implications. NMPO use among adolescents warrants special attention given its prevalence and the high risk of addiction.
Objectives
Our objectives were to: (a) identify factors associated with adolescent NMPO use after controlling for misclassification, while simultaneously identifying characteristics that affected the likelihood of misreporting use; and (b) identify factors associated with an individual misusing their own versus a diverted prescription, and the likelihood that the prescription source was misreported.
Methods
Data come from the Washington State Healthy Youth Survey. A maximum likelihood estimation technique for systematically misclassified binary-dependent variables was utilized. Covariates were chosen to represent influential factors identified in the theoretical adolescent development literature.
Results
An estimated 35 % of respondents who stated that they had never misused prescription opioids most likely had. An estimated 17 % of those who admitted to NMPO use claimed to have misused a diverted prescription, but most likely misused their own. Various demographic, school, neighborhood, family, substance-use, personality/attitude, and social factors were identified as potential predictors of adolescent NMPO use, opioid-prescription source, and misclassification of responses to each outcome.
Conclusions
The finding that a self-reported survey failed to identify over one-third of individuals at risk for NMPO use is concerning, as is the finding that approximately 17 % of those who admitted to NMPO use may have misstated their prescription-opioid source. The findings presented here are critical to focus prevention efforts, especially for identifying at-risk youths who may misrepresent their use.
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Acknowledgments
Dr. Murphy was supported by a seed grant from the Governor’s Washington State Life Science Discovery Fund (Roll, PI) to the Program of Excellence in Rural Mental Health and Substance Abuse Treatment.
Author Contributions
Dr. Murphy is the primary researcher. Drs. Murphy, Rosenman and Friesner all contributed to the conception and design of the study. Dr. Murphy acquired the data, performed the statistical analyses and wrote the initial draft. Drs. Rosenman and Friesner provided input on the statistical approach, performed critical reviews and collaborated with Dr. Murphy on manuscript revisions. All authors approved the final manuscript and are responsible for the final content.
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Murphy, S.M., Friesner, D.L. & Rosenman, R. Opioid Misuse Among Adolescents: New Evidence from a Misclassification Analysis. Appl Health Econ Health Policy 13, 181–192 (2015). https://doi.org/10.1007/s40258-015-0151-z
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DOI: https://doi.org/10.1007/s40258-015-0151-z