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New research finds opioid misuse among youth and young adults has declined over time

Researchers used a birth cohort approach to examine trends in opioid misuse among individuals ages 12 to 21

RESEARCH TRIANGLE PARK, N.C. — A new study conducted by RTI International, a nonprofit research institute, has found that misuse of opioids among U.S. youth and young adults declined from 2002 to 2019. The paper, authored by RTI’s Lauren Klein Warren, Joëlla Adams, Ph.D. and Georgiy Bobashev, Ph.D., was published in the Journal of the American Medical Association (JAMA).

Specifically, the study found that between 2002 and 2019, the rate of past-year opioid misuse in single-age populations decreased over time. For example, 16-year-olds in 2002 had 2.8% higher opioid misuse rates compared to 16-year-olds in 2008. Likewise, rates of opioid misuse among 16-year-olds in 2008 were 3.9% higher than 16-year-olds in 2014. The 2002 cohort had a 12.3% rate of opioid misuse among those aged 19, while the 2011 cohort had a rate of 5%.

In the 2002 and 2005 cohorts, males had significantly lower rates of past-year opioid misuse than females (3.7% and 3.3%, respectively). The rates of misuse were not as distinct between sexes in later cohorts, in part due to the lower overall rates.

“One of the challenges we aimed to solve was the inability to follow up with specific individuals over time,” said Dr. Bobashev, study co-author and Senior Fellow at RTI. “By using data from large national surveys and person-level analysis weights, we were able to track behaviors of individuals in single-age subpopulation cohorts. This allowed us to examine long-term trajectories which were representative of the underlying population.”

The research team examined more than 114,000 individuals in five single-age subpopulation cohorts using data from the annual National Survey on Drug Use and Health (NSDUH) to analyze trends in opioid misuse over time. For each birth cohort, individuals were analyzed starting at 12 years old and were categorized by age until the cohort reached age 21 or the 2019 survey year. The sample included cohorts of individuals who were age 12 in 2002, 2005, 2008, 2011 and 2014.

The decrease in misuse among later cohorts could be explained by a decrease in the availability of illicit drugs and an increase in the exposure to messaging about the harms of opioid use in recent years according to the authors, who plan to use the birth cohort approach in future research on differences in substance use by other sociodemographic characteristics. 

This study was supported in part by the National Institute on Drug Abuse of the National Institutes of Health under grant number 5R01DA047994. The content presented in this release is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Read the full paper

Learn more about RTI’s substance use research