Patients receiving prescription opioid medications are at a high risk of overdose and addiction. However, most studies evaluating prescription opioid overdose have always focused on older adults. This study aims to investigate the opioid prescribing patterns associated with prescription opioid overdose in adolescents and young adults.

This retrospective cohort study included a total of 2,752,612 patients aged 12-21 years with opioid prescription claims. The researchers converted opioid prescription claims into person-days. Logistic regression with clustered SEs was used to evaluate the occurrence of an overdose on a person-day. The primary outcome of the study was the incidence of an opioid overdose.

Of 2,752,612 patients, 1,451,918 participated in the study. The included patients had 4,686,355 prescription claims that corresponded to 21,605,444 person-days. Of the patients, overdose occurred in 249 patients (0.01%) on 255 person-days. The findings suggested that each increase in the daily opioid dosage category was linearly associated with the overdose risk (adjusted odds ratio 1.18). When compared with no-use, both concurrent benzodiazepine (AOR 1.83) and extended-release opioid use (AOR 2.01) was related to a higher risk of overdose.

The research concluded that prescribing opioids to adolescents and young adults was associated with a risk of overdose, which was more significant in highly effective doses.