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Teen Opioid Prescriptions Raise Risk of Later Opioid Misuse

Recent research has highlighted concerns that legitimate medicinal use of prescribed opioid pain medications may be a pathway to opioid misuse and opioid use disorders among adults, raising new questions about the risks versus benefits of these drugs in treating some forms of chronic pain. A new study using data from the NIDA-funded Monitoring the Future survey of adolescent drug use and attitudes conducted annually by the University of Michigan shows that teens who received a prescription for opioid pain medication by Grade 12 were at 33 percent increased risk of misusing an opioid between ages 19 and 25. Strikingly, the risk was found to be most concentrated among teens who would be expected to be at low risk of drug misuse: those with no illicit drug experience and those who reported that they disapproved of regular marijuana use. Among those with low predicted risk of future opioid use in 12th grade, having an opioid prescription increased their risk of post-high-school opioid misuse three-fold.

The authors of the study note that for these individuals, an opioid prescription is likely to be their first exposure to an addictive substance; the pleasurable effects coupled with a sense that it is safe (because medically prescribed) may encourage subsequent misuse. An initial opioid experience may make less impression on teens with more drug-experience. These findings add weight to current concerns about opioid prescribing across healthcare settings and suggest the need for caution among providers working with pediatric populations and providing advice/education about these substances when prescribing. Young patients who are already wary of illicit drug use may be particularly receptive to cautionary messages about misusing opioids.


  • Miech, R., Johnston, L., O’Malley, P.M., et al. Prescription opioids in adolescence and future opioid misuse. Pediatrics 136(5):1169-1177, 2015. [Pubmed]

This page was last updated December 2015

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