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

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


Purpose: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Prescription opioid use; Substance use; Trauma/Injury.

Publication types

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

MeSH terms

  • Adolescent
  • Age Factors
  • Analgesics, Opioid / therapeutic use*
  • Child
  • Female
  • Humans
  • Injury Severity Score
  • Male
  • Marijuana Smoking
  • Pain Measurement
  • Pain, Postoperative / prevention & control
  • Prescription Drug Misuse*
  • Risk Factors
  • Substance-Related Disorders / etiology*
  • Surveys and Questionnaires
  • Wounds and Injuries / drug therapy*


  • Analgesics, Opioid