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Majority of Adolescents With Most Severe SUD Symptoms Have At Least 2 SUD Symptoms as Adults
A majority of adolescents with severe substance use disorder (SUD) symptoms were found to have at least 2 SUD symptoms, suggesting that this population does not transition out of symptomatic substance use later in life, according to a study published by JAMA Network Open on Friday. Further, clinicians should be aware that many adults who are prescribed controlled substances may have had SUD symptoms during adolescence and require careful assessment.
The study was conducted by researchers from the University of Michigan.
Study lead author Sean Esteban McCabe, PhD, professor of nursing and director of the university’s Center for the Study of Drugs, Alcohol, Smoking, and Health, called the findings “a major wake-up call” in a news release.
“We must rethink how we screen and prescribe to individuals who have multiple substance use disorder symptoms in their past, because they might need additional help to take their medication safely,” Dr McCabe said. “For example, some people in long-term recovery from substance use disorders use ‘gatekeepers’ to help dispense and dispose of medications, and lockboxes to reduce access to only the gatekeepers.”
From 1976 to 1986, cohorts of 12th grade students were followed from ages 18 to 50 (2008-2018) in the Monitoring the Future study. Baseline surveys were self-administered in classrooms, and follow-ups were conducted by mail. Surveys measured SUD symptoms, prescription drug use, and prescription drug misuse. The research began with 5317 individuals, and its 32-year retention rate was 53%.
Among the study’s findings:
- 61.6% of those who had the most severe SUD symptoms at the age of 18 had at least 2 SUD symptoms in adulthood. The association held for baseline alcohol, cannabis, and other drug use disorder symptoms.
- Adolescents with the highest SUD symptom severity at age 18 had the highest adjusted odds of prescription drug use and misuse in adulthood.
- 52.2% of adults prescribed opioids, sedatives, or tranquilizers within the past year had multiple SUD symptoms at age 18.
“Notably, most adolescents with severe SUD symptoms do not mature out of symptomatic substance use during the transition from adolescence to adulthood,” the researchers wrote. “Continued education of adolescents and young adults can promote healthy relationships with prescription drugs and other substances to prevent substance use during adolescence in an attempt to mitigate SUD through adulthood.”
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