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J Adolesc Health. 2016 Jan;58(1):92-7. doi: 10.1016/j.jadohealth.2015.08.011. Epub 2015 Oct 23.

Predictors of Sustained Prescription Opioid Use After Admission for Trauma in Adolescents.

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Department of Medicine, Division of Emergency Medicine, University of Washington, Seattle, Washington; Harborview Injury Prevention & Research Center, Seattle, Washington. Electronic address:
Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, Washington.
Harborview Injury Prevention & Research Center, Seattle, Washington.
Department of Emergency Medicine, Alpert Medical School, Brown University, Providence, Rhode Island.
Harborview Injury Prevention & Research Center, Seattle, Washington; Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, Washington.



The study objectives are to describe the longitudinal trajectory of prescription opioid use among adolescents requiring a trauma admission and then identify predictors of sustained opioid use.


Randomly sampled adolescents (12-18 years) admitted to a Level I trauma center were surveyed. Follow-up assessments were obtained at 2, 5, and 12 months. Self-reported prescription opioid use, defined as "taking an opioid prescribed by a physician," was obtained at baseline and every follow-up time point. At the baseline interview, validated mental health measures and pain scales were obtained as well as preinjury substance use. A fixed-effects mixed Poisson regression analysis was performed to predict prescription opioid use over time.


A total of 120 adolescents (mean age 15.5 years [1.9 standard deviation], 75% male) completed the baseline interview with 98% follow-up at 12 months. At baseline, 7% of adolescents reported prescription opioid use before their trauma, with rates of prescription opioid use of 52% at 2 months, 13.3% at 5 months, and 12.5% at 12 months after discharge. After adjusting for demographic characteristics and injury severity score, those with sustained prescription opioid use were more likely to report preinjury marijuana use and higher baseline pain scores.


Approximately one in eight adolescents (12.5%) was using prescription opioids 12 months after injury hospitalization. Readily identifiable risk factors predicted sustained prescription opioid use, including preinjury marijuana use and baseline pain score. Screening for substance use including marijuana at the time of injury could help identify patients at risk for both substance use problems and sustained prescription opioid use.


Prescription opioid use; Substance use; Trauma/Injury

[Indexed for MEDLINE]
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