Nonmedical Use of Prescription Opioids and Injury Risk Among Youth

"Here's the 'kicker': School factors associated with opioid misuse among US African American Youth

Recent evidence has suggested that African Americans are at higher risk for opioid misuse, compared to their relative counterparts. However, school factors have largely been ignored. Given that the school is an environment for the development of risky behavior sequalae, more research is warranted on the relationship between opioid misuse and school factors. The present data used pooled 2015-2018 National Survey on Drug Use and Health data to investigate the relationship between opioid misuse and school factors among a national sample of African American adolescents ages 12-17 (n = 7,236). Results revealed that a sizeable percentage of adolescents (3.51%) misused opioids in the past year. Adolescents at highest risk were female, older, in high school, participated in violence, and did not like school. Moreover, a greater percentage (∼33%) revealed the lack of drug education in schools. We believe our findings can inform behavioral health messages and harm reduction efforts.

The nexus between gender, parental supervision, and opioid misuse among justice-involved adolescents

Justice-involved adolescents (JIA) are at higher risk for opioid misuse (OM) and opioid-related overdose than nonoffending adolescents. Untreated OM can lead to severe consequences (e.g., trauma), which may be harsher for female JIA. Therefore, examining risk and protective factors, such as parental supervision, is essential to identify factors that may impact OM. The current study used a statewide, cross-sectional dataset including 79,960 JIA from the Florida Department of Juvenile Justice. Stratified logistic regression analyses were conducted. Results indicated that JIA who experienced sporadic or inadequate supervision had 2.14 and 3.54 higher odds, respectively, of misusing opioids compared to JIA who experienced consistent supervision. Female JIA who experienced sporadic or inadequate supervision had 2.23 and 3.70 higher odds, respectively, of misusing opioids. Results suggest parental supervision is an important protective factor that should be considered in developing prevention and treatment efforts that serve JIA who misuse opioids, especially females.

The Student Athlete Wellness Portal: Translating Student Athletes’ Prescription Opioid Use Narratives into a Targeted Public Health Intervention

Background and Objectives: The opioid epidemic has permeated all strata of society over the last two decades, especially within the adolescent student athletic environment, a group particularly at risk and presenting their own challenges for science and practice. This paper (a) describes the development of a web-based intervention called the Student Athlete Wellness Portal that models effective opioid misuse resistance strategies and (b) details the findings of a single-group design to test its effectiveness. Materials and Methods: Formative research included 35 student athletes residing in the United States, ages 14 to 21, who had been injured in their school-based sport. They participated in in-depth qualitative interviews to explore narratives relating to their injuries and pain management plans. Inductive analyses of interview transcripts revealed themes of the challenges of being a student athlete, manageable vs. unmanageable pain, and ways to stay healthy. These themes were translated into prevention messages for the portal, which was then tested in a single-group design. Results: Users of the portal (n = 102) showed significant decreases in their willingness to misuse opioids and increases in their perceptions of opioid risks. Conclusions: This manuscript illuminates the processes involved in translating basic research knowledge into intervention scripts and reveals the promising effects of a technology-based wellness portal.

Guidelines for Opioid Prescribing in Children and Adolescents After Surgery: An Expert Panel Opinion

IMPORTANCE

Opioids are frequently prescribed to children and adolescents after surgery. Prescription opioid misuse is associated with high-risk behavior in youth. Evidence-based guidelines for opioid prescribing practices in children are lacking.

OBJECTIVE

To assemble a multidisciplinary team of health care experts and leaders in opioid stewardship, review current literature regarding opioid use and risks unique to pediatric populations, and develop a broad framework for evidence-based opioid prescribing guidelines for children who require surgery.

EVIDENCE REVIEW

Reviews of relevant literature were performed including all English-language articles published from January 1, 1988, to February 28, 2019, found via searches of the PubMed (MEDLINE), CINAHL, Embase, and Cochrane databases. Pediatric was defined as children younger than 18 years. Animal and experimental studies, case reports, review articles, and editorials were excluded. Selected articles were graded using tools from the Oxford Centre for Evidence-based Medicine 2011 levels of evidence. The Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument was applied throughout guideline creation. Consensus was determined using a modified Delphi technique.

FINDINGS

Overall, 14 574 articles were screened for inclusion, with 217 unique articles included for qualitative synthesis. Twenty guideline statements were generated from a 2-day in-person meeting and subsequently reviewed, edited, and endorsed externally by pediatric surgical specialists, the American Pediatric Surgery Association Board of Governors, the American Academy of Pediatrics Section on Surgery Executive Committee, and the American College of Surgeons Board of Regents. Review of the literature and guideline statements underscored 3 primary themes: (1) health care professionals caring for children who require surgery must recognize the risks of opioid misuse associated with prescription opioids, (2) nonopioid analgesic use should be optimized in the perioperative period, and (3) patient and family education regarding perioperative pain management and safe opioid use practices must occur both before and after surgery.

CONCLUSIONS AND RELEVANCE

These are the first opioid-prescribing guidelines to address the unique needs of children who require surgery. Health care professionals caring for children and adolescents in the perioperative period should optimize pain management and minimize risks associated with opioid use by engaging patients and families in opioid stewardship efforts.

Are media literacy interventions effective at changing attitudes and intentions towards risky health behaviors in adolescents? A meta-analytic review

Youth are inundated with media products promoting risky health behaviors (RHBs), including substance use and risky sexual activity. Media literacy interventions emphasize critical media consumption to decrease RHBs. However, it is unclear whether they positively influence attitudes and behavioral intentions towards RHBs. We conducted meta-analyses of 15 studies (N = 5000) testing intervention effectiveness on media literacy skills and 20 studies (N = 9177) testing effectiveness on attitudes and intentions towards RHBs. We found positive effects on media literacy skills (Hedge's g = .417, [95% CI, .29-.54]) and attitudes and intentions (Hedge's g = .100 [95% CI, .01-.19]). Intervention medium and target behavior moderated intervention success on attitudes and intentions, but no moderators emerged for media literacy skills. These interventions produce positive effects on media literacy skills and positive but smaller effects on attitudes and behavioral intentions, depending on medium and target behaviour. Implications for adolescent health initiatives are discussed.