Citation

Parker MA, Anthony JC. Exp. Clin. Psychopharmacol. 2019; 27(1): 87-95.

Affiliation

Department of Epidemiology and Biostatistics, Michigan State University.

Copyright

(Copyright © 2019, American Psychological Association)

DOI

10.1037/pha0000229

PMID

30265064

Abstract

Among young people who start using prescription pain relievers (PPRs) for feeling-states such as "to get high" or otherwise beyond boundaries intended by prescribers, the most recent epidemiological incidence estimates show 2%-9% with rapid-onset opioid dependence. In this work, we study recently active underage alcohol dependence as a susceptibility marker and estimate alcohol dependence-associated PPR rates of use, once use starts. In recent U.S. epidemiological samples, we identified 16,125 community-dwelling 12-to-20-year-olds with standardized assessments of both problem drinking and newly incident extra-medical PPR use. We applied zero-inflated Poisson (ZIP) regressions to estimate (a) alcohol dependence associations with susceptibility-to-persist after the very first occasion of extra-medical PPR use, and (b) the rate of PPR use, conditional on persistence. Underage drinkers with alcohol dependence were more susceptible to persistence in their extra-medical PPR use (p <.001). In addition, given susceptibility-to-persistence, there was an alcohol dependence-associated excess rate of extra-medical PPR use (risk ratio = 1.3; 95% confidence interval = 1.1, 1.6). Using ZIP regressions, we can see that underage alcohol dependence signals membership in a susceptible-to-persistence class of extra-medical PPR users and excess rates of extra-medical use. Underage drinking can be an indicator of greater vulnerability to start and persist in extra-medical use of PPR, particularly if presenting clinical features of alcohol dependence already are seen at or near time of first onset of such PPR use. For alcohol dependence-affected adolescent patients, nondrug pain management plans deserve consideration, with special surveillance if analgesic drugs are prescribed. Implications for genetic susceptibility research are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Language: en