Past-year prevalence of prescription opioid misuse among those 11 to 30 years of age in the United States: A systematic review and meta-analysis

Abstract

Background There are high levels of prescription and consumption of prescription opioids in the US. Misuse of prescription opioids has been shown to be highly correlated with prescription opioid-related morbidity and mortality including fatal and non-fatal overdose. We characterized the past-year prevalence of prescription opioid misuse among those 11–30 years of age in the US. Methods A systematic review and meta-analysis were carried out following a published protocol and PRISMA guidelines. We searched electronic databases; reports were eligible if they were published between 1/1/1990-5/30/2014, and included data on individuals 11 – 30 years of age from the US. Study quality was assessed using the Newcastle-Ottawa Scale. Results A total of 3,211 abstracts were reviewed for inclusion; after discarding duplicates and identifying non-eligible reports, a total of 19 unique reports, providing 34 estimates, were included in the final systematic review and meta-analysis. The range of past-year prescription opioid misuse prevalence the reports was 0.7% – 16.3%. An increase in prevalence of 0.4% was observed over the years of data collection. Conclusions This systematic review and meta-analysis found a high prevalence of past-year prescription opioid misuse among individuals 11–30 years of age. Importantly, we identified an increase in past-year prevalence 1990–2014. Misuse of prescription opioids has played an important role in national increases of fatal and non-fatal drug overdose, heroin use and injection, and HIV and HCV infection among young people. The observed high and increasing prevalence of prescription opioid misuse is an urgent public health issue.

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“…Additionally, Jordan et al. produced a systematic review and meta‐analysis of 19 assessments of prescription opioid misuse among patients 11 to 30 years of age, from 1990 to 2014, and reported “high and increasing prevalence” within this population, a prevalence that increased by approximately 0.4% each year . The progressive increase identified within our analysis occurred despite changing societal awareness of OUD, changing prescription habits by providers with opioid prescribing privileges, and increased availability of opioid dependence programs from 2011 to 2015 .…”

“…27 Additional reports also cite the highest prevalence among young adults. 24,28,29 Results also indicate that mean length of stay, provider interventional procedure rates, and discharge pathway remained stable from 2011 to 2015. Hospital length of stay for admissions related to OUD ranged from 5.74 to 5.82 days.…”

“…23 Additionally, Jordan et al produced a systematic review and metaanalysis of 19 assessments of prescription opioid misuse among patients 11 to 30 years of age, from 1990 to 2014, and reported "high and increasing prevalence" within this population, a prevalence that increased by approximately 0.4% each year. 24 The progressive increase identified within our analysis occurred despite changing societal awareness of OUD, changing prescription habits by providers with opioid prescribing privileges, and increased availability of opioid dependence programs from 2011 to 2015. 25,26 Conversely, it is possible that increased rates of OUD may be at least partially related to increased attention in mainstream media and academia alike, and that increased awareness may have contributed to increased identification, reporting, and resource utilization.…”

“…Higher and more rapidly increasing prevalence of opioid misuse–related emergency department visits have also been reported among patients 19 to 29 years of age . Additional reports also cite the highest prevalence among young adults …”

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“…The injecting of prescription opioids has increased considerably over the past two decades in North America (Fischer & Argento, 2012;Jordan, Blackburn, Des Jarlais, & Hagan, 2017;B. D. Marshall, Green, Yedinak, & Hadland, 2016) and internationally (B. D. .…”