Mental health disorders and long-term opioid use among adolescents and young adults with chronic pain

J Adolesc Health. 2012 Jun;50(6):553-8. doi: 10.1016/j.jadohealth.2011.11.011. Epub 2012 Feb 28.


Purpose: The purpose of this study was to examine the association between mental health disorders and subsequent risk for long-term opioid use among adolescents and young adults presenting with common chronic pain complaints (back pain, neck pain, headache, and arthritis/joint pain).

Methods: Using claims data from January 1, 2001 to June 30, 2008, we conducted a longitudinal analysis of opioid use patterns among 13-24-year-old subjects presenting with a new episode of chronic pain. Long-term opioid use was defined as receiving >90 days of opioids within a 6-month period with no gap of >30 days in use of opioids in the 18 months after the first qualifying pain diagnosis. Mental health disorders were identified from claims in the 6 months before the first qualifying pain diagnosis.

Results: Fifty-nine thousand seventy-seven youth met criteria for a new episode of chronic pain. Among these youth, 321 (.5%) met criteria for long-term opioid use, and 16,172 (27.4%) had some opioid use. After controlling for demographic and clinical factors, youth with preexisting mental health diagnoses had a 2.4-fold increased risk of subsequently receiving long-term opioids versus no opioids (odds ratio = 2.36, 95% confidence interval = 1.73-3.23) and a 1.8-fold increased likelihood of receiving long-term opioids versus some opioids (odds ratio = 1.83, 95% confidence interval = 1.34-2.50).

Conclusions: Mental health disorders are associated with increased risk for long-term opioid use among adolescents and emerging young adults. Further study is warranted to examine risks and benefits of long-term opioid use in this population.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Analgesics, Opioid / administration & dosage*
  • Analgesics, Opioid / adverse effects*
  • Chronic Pain / diagnosis
  • Chronic Pain / drug therapy
  • Chronic Pain / epidemiology*
  • Chronic Pain / psychology
  • Comorbidity
  • Diagnosis, Dual (Psychiatry)
  • Female
  • Health Surveys
  • Humans
  • Long-Term Care
  • Longitudinal Studies
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / epidemiology*
  • Mental Disorders / psychology
  • Odds Ratio
  • Opioid-Related Disorders / diagnosis
  • Opioid-Related Disorders / epidemiology*
  • Opioid-Related Disorders / psychology
  • Pain Measurement / drug effects
  • Risk Factors
  • United States
  • Young Adult


  • Analgesics, Opioid