Two new studies offer insight into how people get hooked on opioids. One critical way is taking prescription narcotics: The risk of transitioning from short-term to long-term opioid uses spikes after only eight days of taking narcotic pain pills, according to a study from the U.S. Centers for Disease Control and Prevention. But there’s a second major risk for young people, too. According to a new study in the journal Pediatrics, keeping unsecured opioids in the home is a key point of opioid exposure for children and teenagers.
These findings shed light on what’s been a tension point in the medical community. Although patients require safe and effective pain treatments, some doctors overprescribe opioids, and given their highly addictive nature, they can wreak further havoc on the health of patients ― or that of their families.
It doesn’t take long to get hooked on pain pills
The switch from acute to long-term opioid use can happen in a matter of days. According to a March 17 CDC report, people who use opioids for one day have a 6 percent chance of continuing to use them a year later. That risk for long-term use jumps to 13 percent after eight days of opioid use. And although very few patients receive month-long opioid prescriptions, those who do are at a 30 percent chance of continuing to use them a year later.
“The initial prescription a clinician writes has a pretty profound impact on a person’s (likelihood) for being a long-term opioid user,” Bradley Martin, study author and head of the Division of Pharmaceutical Evaluation and Policy at the University of Arkansas for Medical Sciences College of Pharmacy, told CNN.
Children of all ages are exposed to opioids
Adults aren’t the only victims of the United States’ ongoing opioid crisis. Teenagers, preteens and children younger than age 5 are all at risk for opioid exposure, according to a study published March 20 in Pediatrics.
“We’ve known for several years about the opioid epidemic affecting adults in this country,” Dr. Gary Smith, study author and director of the Center for Injury Research and Policy at Nationwide Children’s Hospital, told The Huffington Post. “When adults bring these medications into their homes, they can become a danger to the children that live there.”
The study examined 188, 468 prescription opioid exposure reports from poison control centers in the United States between 2000 and 2015. It found that the number of opioid exposures increased by 86 percent between 2000 and 2009, then fell by about 30 percent between 2009 and 2015.
There were also trends in how children and young adults of different ages were exposed to opioids.
Children 5 years old and younger were most likely to accidentally encounter opioids through “exploratory exposure.” Six- to 12-year-olds were usually exposed because of medication errors, such as being given the wrong dose of a drug. Teenagers were mostly likely to come in contact with opioids intentionally, by misusing opioids recreationally or as a self-harm mechanism.
In fact, suspected opioid-related suicides among teenagers rose 53 percent between 2000 and 2015.
Teenage opioid use over time
A long-term companion study also published in Pediatrics on March 20 found that 1 in 4 high school seniors reported medical or non-medical prescription opioid use, with peak use in both 1989 and 2002 and a decline in opioid use from 2013 through 2015.
The researchers also found a strong correlation between teens taking opioids for medical reasons before trying them recreationally.
“One consistent finding we observed over the past two decades is that the majority of nonmedical users of prescription opioids also have a history of medical use of prescription opioids,” Sean McCabe, study author and research professor at the University of Michigan, told Live Science.
And a population-level decline in teen opioid use doesn’t mean every community has experienced opioid use decline.
“Opioid use disproportionately affects some urban and more rural areas,” Dr. David Rosen, professor of anesthesia and pediatrics at West Virginia University, noted in an accompanying editorial.
“Americans consume 80 percent of the world’s prescription opioids, and inappropriate use takes a high toll on society,” Rosen wrote. “We are heartened to see a recent decrease, but we see it as a measured improvement.”
How to keep opioids out of the hands of kids
The was one exception to the decline in calls between 2009 and 2015 to poison control centers for youth exposure to opioids. That was calls related to buprenorphine, an opioid addiction treatment.
Buprenorphine-related calls rose during that time period, with 90 percent of those exposures in children under the age of 5, an indication that many adults fail to properly secure their medication.
Storing prescription opioids out of the reach of small children, and importantly, locked up, is paramount. Parents can also keep the number for poison control in their cell phones, in case of an emergency.
For teenagers, especially those who may be at risk for self-harm, the solution is more complex than keeping medication locked away or on a high shelf.
Teens need to be educated about the dangers of opioid use, according to Smith. Public health interventions, such as expanding access to naloxone (the opioid overdose reversal drug) and improving teenagers’ access to mental health services are similarly important.
Doctors can also do their part by following Surgeon General Vivek Murthy’s recommendation to prescribe pain patients the lowest possible opioid dose for the shortest amount of time. Proper prescribing practices help ensure that patients aren’t left with a surplus of pills, which have the potential to fall into the wrong hands.
“While overall rates of exposure to opioids among children are going down, they are still too high,” Smith said. “We need to continue to examine our prescription practices and to increase education to parents about safe ways to store these medications at home to keep them out of the hands of children.”