204 - Patterns of Substance Use Initiation Among Adolescents and Young Adults with Opioid Use Disorder

Poster Number: 204
Publication Number: 204.400

Madeline L. Watson, Ohio State University College of Medicine, Columbus, OH, United States; Erin R. McKnight, Nationwide Children's Hospital, Columbus, OH, United States; Judith Groner, Nationwide Children's Hospital, Columbus, OH, United States; Brittny E. Manos, Nationwide Children's Hospital, Columbus, OH, United States; Ashley Ebersole, Divison of Adolescent Medicine at Nationwide Children's Hospital, Columbus, OH, United States; Andrea E. Bonny, Nationwide Children's Hospital, Columbus, OH, United States

Background: Prior research has described many genetic and environmental factors that contribute to adolescent substance use disorders (SUD). This is cause for concern, as it has been shown that use of nicotine and marijuana in adolescence can both modulate the reinforcing effects of opioids and contribute to a “gateway” effect for future opioid misuse. There is currently a large population of adolescents and young adults (AYAs) with opioid use disorder (OUD). Patterns of nicotine and marijuana use in this population have not been thoroughly explored, and additional data is needed to guide practice to best meet the needs of these patients.

Objective: This cross-sectional study aimed to describe patterns of nicotine and marijuana use among AYAs receiving medication-assisted treatment (MAT) for OUD.

Design/Methods: The Youth Nicotine and Tobacco Survey was adapted to include questions about e-cigarette and marijuana use. It was administered via REDCap to participants (n=32) receiving outpatient care in the Medication-Assisted Treatment of Addiction clinic at Nationwide Children’s Hospital (NCH) in Columbus, OH. Participants received a $10 gift card upon survey completion. The NCH institutional review board approved all procedures.

Results: Demographic data is shown in Table 1. Nearly 70% of participants reported having an immediate family member with SUD. Many participants initiated substance use in early adolescence, with 68.8% of participants first using nicotine, marijuana, or opioids by 13 years old or younger. By 15 years old, 62.5% of participants reported trying opioids, 86.6% had tried marijuana, and 87.1% had tried combustible cigarettes (Table 2). Nearly all participants (96.7%) reported trying all three substances. This population endorsed high rates of current nicotine use, with over 70% smoking cigarettes every day for the past 30 days. Nearly half of participants (48.4%) reported smoking on average over 10 combustible cigarettes per day over the past 30 days. Almost 90% of participants have tried e-cigarettes, but only 32.4% reported using an e-cigarette within the last 30 days. Many participants (63.4%) reported a desire to use nicotine within 30 minutes of waking, suggesting a high level of nicotine dependence. Conclusion(s): Among AYAs receiving MAT for OUD, nearly all reported early age of first use of opioids, marijuana, and nicotine and high rates of polysubstance use in adolescence. Pediatric providers must be aware of these patterns and consider earlier screening for substance use, particularly for patients with a family history of SUD.
Madeline Watson CVmadeline-watson-cv.pdf
Table 2. Age of Substance Use InitiationAge at which participants first tried opioids, marijuana, cigarettes, and e-cigarettes