Long-term Prescription Opioid Utilization after Pediatric Trauma
Teresa M. Bell, PhD1; Jodi L. Raymond, MPH2; Ashley Vetor, MPH1; Alejandro Mongalo, MS1; Zachary W. Adams, PhD1; Thomas M. Rouse, MD, FACS3; Aaron E. Carroll, MD, MS1
1Indiana University, Indianapolis, IN; 2Riley Hospital for Children at Indiana University Health, Indianapolis, IN; 3Indiana University and Riley Hospital for Children at Indiana University Health, Indianapolis, IN
BACKGROUND – Injured adolescents have a 56% increased risk of developing a substance use disorder (SUD) within 3 years of their injury. The transition from medical prescription opioid use to nonmedical use in adolescent trauma patients has not been longitudinally studied long-term. The aim of this study is to describe 5-year patterns of opioid use in a retrospective cohort of injured adolescents as well as the incidence of overdose and SUD diagnosis.
METHODS – Our cohort consisted of 668 patients ages 12-18 admitted for trauma from 2011-2013. We examined up to 5 years of regional health information exchange data containing information on prescription and health service utilization.
RESULTS – At 1 year, over 20% of adolescents filled more than 2 opioid prescriptions after being discharged for their injury; and at 4 years, over 13% had received more than 8 opioid fills. Over the 5 year period, 11% received an opioid antagonist injection, 14% received an SUD diagnosis, and 8% had an overdose diagnosis. Relatively few patients had diagnoses for other mental health conditions including depression (5.5%), PTSD (2.1%), and chronic pain (3.6%).
CONCLUSIONS – Opioid usage remains high for multiple years in a subset of the adolescent trauma population. Mental health diagnosis rates were much lower in injured adolescents than what has been reported in adults. However, overdose and SUD diagnoses occur in over 1 in 10 adolescents within 5 years of their injury.
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