A large US study offered insight on how variations in opioid prescribing can increase risk for detrimental outcomes — namely, opioid use disorder or opioid overdose. Researchers searched a comprehensive database of health insurance claims for individuals with employer-provided coverage, identifying more than three million 11- to 25-year-olds by their first opioid prescription. They found that longer-acting medications led to 159% increased risk of being diagnosed with opioid use disorder or experiencing an opioid overdose in the year following the initial prescription — compared with outcomes for shorter-acting formulations.

Duration also made a difference. Prescriptions for 15 days or longer increased risk by 96%, while those for seven to 14 days increased risk by 15% — compared with prescriptions for three days or fewer. As well, higher daily doses (i.e., morphine equivalents of 90 milligram or greater) increased risk for detrimental outcomes by 23% compared with doses of less than 30 milligrams. These findings highlight the importance of using caution when prescribing opioids to young people.

For more information, see Vol. 18, No. 3 of the Children’s Mental Health Research Quarterly.