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Int J Drug Policy. 2016 May;31:25-31. doi: 10.1016/j.drugpo.2016.01.022. Epub 2016 Feb 4.

Harm reduction for young people who use prescription opioids extra-medically: Obstacles and opportunities.

Author information

1
Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Box G-S-121-2, Providence, RI 02912, USA. Electronic address: brandon_marshall@brown.edu.
2
Boston University School of Medicine, Department of Emergency Medicine, 771 Albany Street, Room 1208, Boston, MA 02118, USA; The Warren Alpert School of Medicine of Brown University, Rhode Island Hospital, 55 Claverick Street, Providence, RI 02903, USA.
3
Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Box G-S-121-2, Providence, RI 02912, USA.
4
Division of Adolescent/Young Adult Medicine, Department of Medicine, Boston Children's Hospital, 333 Longwood Avenue, Boston, MA 02115, USA; Department of Pediatrics, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Department of Health Policy & Management, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.

Abstract

Extra-medical prescription opioid (EMPO) use - intentional use without a prescription or outside of prescribed parameters - is a public health crisis in the United States and around the world. Epidemiological evidence suggests that the prevalence of EMPO use and adverse sequelae, including opioid overdose and hepatitis C infection, are elevated among people aged 18-25. Despite these preventable health risks, many harm reduction interventions are underutilized by, or inaccessible to, EMPO-using youth. In this commentary, we describe key harm reduction strategies for young people who use prescription opioids. We examine individual, social, and policy-level barriers to the implementation of evidence-based approaches that address EMPO use and related harms among young people. We highlight the need for expanded services and new interventions to engage this diverse and heterogeneous at-risk population. A combination of medical, social, and structural harm reduction interventions are recommended. Furthermore, research to inform strategies that mitigate particularly high-risk practices (e.g., polysubstance use) is warranted. Finally, we discuss how the meaningful involvement of youth in the implementation of harm reduction strategies is a critical component of the public health response to the prescription opioid epidemic.

KEYWORDS:

Adolescence; Harm reduction; Prescription drug misuse; Prescription opioids; Youth

PMID:
26919826
PMCID:
PMC4975034
DOI:
10.1016/j.drugpo.2016.01.022
[Indexed for MEDLINE]
Free PMC Article

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