WEDNESDAY, April 6, 2022 (HealthDay News) — For a majority of adolescents with severe substance use disorder (SUD), symptomatic substance use will persist in middle age, according to a study published online April 1 in JAMA Network Open.

Sean Esteban McCabe, Ph.D., from University of Michigan in Ann Arbor, and colleagues evaluated the longitudinal associations of adolescents’ SUD symptom severity with later medical use of prescription drugs (i.e., opioids, sedatives, and tranquilizers), prescription drug misuse (PDM), and SUD symptoms at ages 35 to 50 years. The analysis included 11 cohorts of U.S. 12th grade students (5,317 students) who were followed longitudinally from age 18 years (1976 to 1986) to age 50 years (2008-2018) as part of the Monitoring the Future study.

The researchers found that 12 percent of 18-year-olds had severe substance use disorder, and a majority of adolescents with the most severe SUD symptoms at age 18 years had two or more SUD symptoms in adulthood (61.6 percent). This association persisted for baseline alcohol, cannabis, and other drug use disorder symptoms. The highest adjusted odds of prescription drug use and prescription drug misuse in adulthood (adjusted odds ratios: four to five symptoms, 1.56; six or more symptoms, 1.55) were seen among adolescents with the highest SUD symptom severity at age 18 years. Multiple SUD symptoms at age 18 years were present for the majority of adults using prescribed opioids, sedatives, or tranquilizers (52.2 percent) in the past year.

“Prescribers must be aware that many adults prescribed controlled substances had SUD symptoms during adolescence and require careful assessment,” the authors write.

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