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HHS Bulletin: The Opioid Epidemic: A Focus on Adolescents

Defining the Issue:
The opioid epidemic affects individuals and communities across the United States in a variety of ways. Opioids are a broad class of drugs that relieve pain and include prescription pain relievers, synthetic drugs such as fentanyl, and heroin. Overall, overdose deaths from heroin and other opioids have increased over the past decade, and the public, private, and nonprofit sectors are working to address the growing epidemic.

The Numbers:
In 2016, 3.6 percent of adolescents ages 12-17 had misused opioids over the past year, a figure that has remained stable over the past decade. However, overdose deaths from opioids for adolescents ages 15-19 increased from 1999 through 2007, declined from 2007-2014, and then began rising again in 2015.

Adolescents at Risk:
All adolescents are at risk for misusing opioids, even those who have not previously used drugs and who disapprove of illegal drug use. In fact, there is a 33 percent increased risk of future opioid misuse if a high school student uses opioids as prescribed by a doctor.

Few adolescents with an opioid use disorder (OUD) receive treatment, and disparities exist. From 2001 to 2014, for insured youth with an OUD, only one in four received treatment. Females were less likely to receive treatment compared to males, and youth who were Hispanic or non-Hispanic black were less likely to receive treatment than their non-Hispanic white counterparts.

Preventing Opioid Misuse:
The fact that the adolescent brain is still growing means that teens are vulnerable to addiction, but the adolescent brain is also ripe for learning healthy habits and behavior.

To help prevent opioid misuse, those who care about and for adolescents should:

  • Treat pain cautiously. Adolescents often are initially exposed to opioids through prescriptions; dentist prescriptions account for 31 percent of adolescents’ first exposure to opioids. While the effectiveness of alternative treatment options is still being studied, health care providers should turn to other treatment options before prescribing opioids for acute and chronic pain. The National Institutes for Health has pain information for health professionals, and the Turn the Tide pain treatment toolbox also has a range of resources.

  • Talk with teens in your life about pain treatment and management. Regardless of drug use history, reach out to youth. Building strong relationships with adolescents is the first step to connecting with youth on drug prevention. Collaboration between and within youth-serving sectors and community partnerships present opportunities to reach at-risk and drug-naïve adolescents by increasing the efficiency of care, communicating across providers, and breaking down stigmas. Combining services such as trauma-informed care and psychological support with mentors and peers in the same location also can be an effective way to reach and help youth.

  • Act when you suspect an adolescent or someone close to them is misusing opioids. Signs of opioid misuse include: drowsiness, constipation, nausea, dizziness, vomiting, dry mouth, headaches, sweating, and mood changes, among others. If you are concerned about opioid misuse, call the National Helpline at 1-800-662-HELP (4345) and consult the directory for opioid treatment programs in your area.

Additional Resources for Stopping and Preventing Opioid Misuse:

  • Follow Best Practices. The American Academy of Pediatrics’ Committee on Substance Use and Prevention outlines best practices for the health sector to screen, treat, and refer adolescents with substance use issues.

  • Find Research and Resources. The NIH Public-Private Initiative to Address the Opioid Crisis researches “new and improved” approaches to prevent, detect, and reverse overdoses as well as identify nonaddictive treatments for chronic pain. Also, OAH’s Adolescent Health Library has a range of relevant resources on illicit and non-illicit drug use.

  • Utilize Lesson Plans.  Educators can find lesson plans from the National Institute on Drug Abuse that help them inform their students and answer questions about the nature of prescription drug abuse. 

  • Build Relationships. Keeping Youth Drug Free provides parents and caregivers with tips on building strong relationships with adolescents, guidance for tough conversations about substance use, and a list of common drugs and their street names. OAH also has tips on how parents and caregivers can have start these conversations with their teen.

  • Know the Laws. The Prescription Drug Abuse Policy System keeps track of important state laws about prescription drug abuse such as prescription drug monitoring programs, opioid prescribing guidelines, and Good Samaritan overdose prevention laws.