Presented at the 2018 STFM Annual Meeting, entiteld: Adolescent Views on Prescription and Nonprescription Opioid Use: Findings from the MyVoice Longitudinal Mixed Methods Study

1. 54% of youth stated that they could get prescription
pain medication from someone other than a doctor,
top sources include:
“I think it’s the physician’s responsibility to prescribe medication
of the appropriate dose for the appropriate amount of time to
each patient. However, it is, in the end, the patient who is
taking the pain medication and it is their life (if they become
addicted or overdose), so it’s important to be cautious. But I
don’t think it’s unsafe, unless the pain medication is abused.”
–22 year old Asian female
Drug Dealer
22%
Friends
8%
Family
5%
“It’s safe, if a doctor approves
it and has a complete truthful
report on your current
lifestyle and medication, there
isn’t really any reason to
doubt them”
-21 year old White male
Are prescription
pain meds safe to
take?
“Not very safe,
In class we
learned that 60
percent of
people we
were
perscribed (sp)
got addicted”
-19 year old Asian
female
“I used pain pill prescriptions to
aid in my back pain from the age
of 12-18. I became extremely
addicted to them. I would say not
safe at all. Especially with little
doctor management involved. I
kept getting refills and my
doctors weren’t concerned about
me needing a new prescription”
-18 year old Black female
“I would believe it's
safe. Because my
doctor would prescribe
it. And if it isn't safe
and I took it, it would
be my doctors fault”
-14 year old White male
“Safer because your doctor
ideally knows when to give them
to you. But sometimes they are
over prescribed and therefore can
do harm”
-22 year old White male
“Over time our bodies change, which
means your health needs change, which
also means your medication should
change too along with all of that. You be
doing just as much damage taking your
own old meds, as you would do taking
someone else's” -14 year old Black female
“If they are
perscribed (sp) then
that means that they
are necessary and
portioned so that it
is harder to get
addicted”
-16 year old Arab female
• Opioid overdose is now one of the leading causes of accidental death in
the U.S.
• There has been a push at the federal level for better regulation of
opioids through prescription drug monitoring programs and
development of opioid prescribing guidelines for physicians
• The focus has been on addressing the problem at a system and provider
level, but less has been done to address the problem by targeting
prevention efforts at opioid users themselves.
• The majority of substance users initiate drug use in late adolescence, but
the voices of youth has been largely absent from the national
conversation regarding the opioid epidemic.
METHODS
CONCLUSIONS
BACKGROUND
OBJECTIVES
RESULTS
The goal of this ongoing study is to explore adolescent perspectives of
prescription drug misuse in order to inform future intervention and policy
efforts.
• Longitudinal, cross-
sectional text messaging
poll soliciting the
opinions of youth on
health and policy issues.
• U.S. youth 14-24 years
old, with access to a
phone with SMS
capabilities, recruited
primarily through social
media.
• Open-ended survey
questions: (e.g., When it
comes to your health,
how safe is it to use
prescription pain
medication that was
NOT prescribed to you?
Why?; Could you get
prescription pain
medications from
somewhere other than
your doctor? Where?)
• Analysis: Qualitative
thematic analysis
including open coding.
Adolescent Views on Prescription and Nonprescription Opioid Use: Findings
from the MyVoice Longitudinal Mixed Methods Study
Melissa DeJonckheere1, Christina Czuhajewski1, Lauren Nichols1, Joceline Vu2, Calista Harbaugh2, Missy Plegue1, Tammy Chang1,3
1Department of Family Medicine, University of Michigan; 2Department Of Surgery, University Of Michigan;
3Institute for Healthcare Policy and Innovation, University of Michigan
IMPLICATIONS
• The majority of participants view misuse of prescription drugs as a
risky health behavior, particularly when the drugs are obtained
illegally.
• When prescribed by a doctor, prescription pain medication is
viewed as more safe and less likely to be misused.
• Youth placed trust in prescription pain medications that were prescribed by a doctor, indicating that
there is an opportunity to counsel patients when prescribing opioids and other pain medications.
• Because prescription drugs were readily available to adolescents in this sample, more research is
needed to determine whether risk perception influences behavior, particularly in the context of
opioids.
• Intervention and prevention efforts with youth should address misconceptions about prescription
drug misuse.
Participants Demographics
Disseminationback to
participants #WeHearU
Recruited on Facebook or
Instagram
Consent Form & Demographic Survey
(phone number, nickname collected)
Eligibility Survey
(Age collected)
Tutorial
Quantitative Data
(scales, categorical)
Incentives
Eligible
Yes
Recruited from community
event/outreach
Studywebsite
Textmessaging
Qualitative Data
(open-ended)
Weekly Surveys
Figure 1. MyVoice Study Flow
To date, we have received open-ended responses from 546 youth across the U.S.:
• 51% of participants (n=280) had used prescription pain medications (including anti-inflammatories and opioids) in the past, primarily following a surgery (e.g., wisdom teeth
removal) or prescribed for chronic pain (e.g. menstrual cramps, back pain), or traumatic event (e.g. car accident).
• Taking WITHOUT a prescription: The majority of participants felt that using prescription pain medications that were not prescribed is unsafe. 35% noted fear of adverse or
unknown reactions. 29% noted fear of addiction, abuse, or overdosing.
• Taking WITH a prescription: Those who stated that prescriptions were safe or relatively more safe often cited their trust in their doctor’s expertise and responsibility for
oversight of prescribed medications (32% of coded free-text responses) or safety as conditional to taking medications “as prescribed” (27%). For those who stated that
prescriptions were still relatively unsafe, some questioned the prescription, sometimes noting physicians’ overprescribing (8%) practices. Many cited the inherent addictive
quality of some prescription pain killers (15%) or the risk of taking old prescriptions (2%).
N=546 n(%)
Age, mean(SD) 19.0 (3.0)
Gender, n(%)
Male 188 (34.5)
Female 325 (59.5)
Other 33 (6.1)
Race
White 390 (71.6)
Black 45 (8.3)
Asian 59 (10.8)
Other (including multi-racial) 51 (9.4)
Hispanic 56 (10.3)
Education (N=545)
<High School 229 (42.0)
High School grad 46 (8.4)
Some college or tech school 163 (29.9)
Associate’s or tech school
grad
17 (3.1)
Bachelor’s+ 90 (16.5)
Geographic Regions (n=545)
West 47 (8.6)
Midwest 384 (70.5)
South 75 (13.8)
East 39 (7.2)
SES (n=537)
Low (ever received free
lunch)
144 (26.8)
Med/High 393 (73.2)
Find more information at hearmyvoicenow.org