Long Term Effects of Opioid Use in Adolescent Trauma

Infographic · Feb 2020 · 1 min read

In brief

Five-year retrospective study of 736 injured adolescents reveals persistent opioid use patterns, with over 20% filling multiple prescriptions at 1 year and 13% receiving 8+ fills by year 4. Within 5 years post-injury, 14% developed substance use disorder and 8% experienced overdose, highlighting critical need for monitoring in this population.

Over 20% of injured adolescents filled >2 opioid prescriptions at 1 year; 13% had >8 fills by year 4, indicating prolonged use patterns.
Within 5 years post-injury, 14% developed substance use disorder and 8% experienced overdose—affecting >1 in 10 adolescent trauma patients.
Injured adolescents face 56% increased risk of developing substance use disorder within 3 years of trauma admission.
Mental health diagnoses (depression 5.5%, PTSD 2.1%) were substantially lower than adult trauma populations, suggesting underdiagnosis.
Routine screening for opioid misuse and SUD is critical in adolescent trauma follow-up given high long-term prescription continuation rates.

Written by the GCMD Library team from the infographic.

Blue-toned infographic with white text and icons. Left side shows prescription bottle icons. Right side displays three statistics with corresponding icons: a syringe with circular arrow, an eye symbol, and a patient on stretcher. Citation and journal logo appear at bottom.

Injured adolescents have a 56% increased risk of developing a substance use disorder (SUD) within 3 years of their injury. The transition from medical prescription opioid use to nonmedical use in adolescent trauma patients has not been longitudinally studied long-term. The aim of this study is to describe 5-year patterns of opioid use in a cohort of injured adolescents as well as the proportion of patients experiencing overdose and SUD diagnoses.

METHODS

Our retrospective cohort study consisted of 736 patients aged 12 years to 18 years who were admitted for trauma from 2011 to 2013. We examined up to 5 years of regional health information exchange data containing information on prescription fills as well as diagnoses from inpatient, outpatient, and emergency department encounters.

RESULTS

At 1 year, over 20% of adolescents filled more than two opioid prescriptions after being discharged for their injury; and at 4 years, over 13% had received more than eight opioid fills. Over the 5-year period, 11% received an opioid antagonist injection, 14% received an SUD diagnosis, and 8% had an overdose diagnosis. Relatively few patients had diagnoses for other mental health conditions including depression (5.5%), posttraumatic stress disorder (2.1%), and chronic pain (3.6%).

CONCLUSION

Opioid usage remains high for multiple years in a subset of the adolescent trauma population. Mental health diagnosis rates were substantially lower in injured adolescents than what has been reported in adults. However, overdose and SUD diagnoses occur in over 1 in 10 adolescents within 5 years of their injury.

LEVEL OF EVIDENCE

Prognostic and epidemiological study, level IV.

Visual abstract created by Alejandra M Casar Berazaluce, MD - Pediatric Surgery Research Fellow at Cincinnati Children's Hospital Medical Center.

The text in the image

Long Term Effects of Opioid Use in Adolescent Trauma | >13% 8+ Rx Fills | 1 in 9 required reversal. | 1 in 7 Substance Use Disorder. | 1 in 12 had an overdose. | *Retrospective cohort of trauma admissions 2011-2013, age 12-18 years, 5 year follow up, n=736; Indianapolis, IN. | The Journal of Trauma and Acute Care Surgery | Teresa M. Bell, PhD et al. Journal of Trauma and Acute Care Surgery (2019). https://doi.org/10.1097/TA.0000000000002261 | @alejandracasar

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