The added risk of opioid problem use among treatment-seeking youth with marijuana and/or alcohol problem use
Article first published online: 10 MAR 2010
© 2010 The Authors. Journal compilation © 2010 Society for the Study of Addiction
Volume 105, Issue 4, pages 686–698, April 2010
How to Cite
Subramaniam, G. A., Ives, M. L., Stitzer, M. L. and Dennis, M. L. (2010), The added risk of opioid problem use among treatment-seeking youth with marijuana and/or alcohol problem use. Addiction, 105: 686–698. doi: 10.1111/j.1360-0443.2009.02829.x
- Issue published online: 10 MAR 2010
- Article first published online: 10 MAR 2010
- Submitted 11 April 2009; initial review completed 3 June 2009; final version accepted 28 September 2009
- clinical characteristics;
- HIV risk behaviors;
- opioid-dependent youth;
- opioid-use risk;
- problem opioid use;
- psychiatric comorbidity
Objectives To determine the added risk of opioid problem use (OPU) in youth with marijuana/alcohol problem use (MAPU).
Methods A total of 475 youth (ages 14–21 years) with OPU + MAPU were compared to a weighted sample of 475 youth with MAPU only (i.e. no OPU) before and after propensity score matching on gender, age, race, level of care and weekly use of marijuana/alcohol. Youth were recruited from 88 drug treatment sites participating in eight Center for Substance Abuse Treatment-funded grants. At treatment intake, participants were administered the Global Appraisal of Individual Need to elicit information on demographic, social, substance, mental health, human immunodeficiency virus (HIV), physical and legal characteristics. Odds ratios with confidence intervals were calculated.
Results The added risk of OPU among MAPU youth was associated with greater comorbidity; higher rates of psychiatric symptoms and trauma/victimization; greater needle use and sex-related HIV risk behaviours; and greater physical distress. The OPU + MAPU group was less likely to be African American or other race and more likely to be aged 15–17 years, Caucasian; report weekly drug use at home and among peers; engage in illegal behaviors and be confined longer; have greater substance abuse severity and polydrug use; and use mental health and substance abuse treatment services.
Conclusions These findings expand upon the existing literature and highlight the substantial incremental risk of OPU on multiple comorbid areas among treatment-seeking youth. Further evaluation is needed to assess their outcomes following standard drug treatment and to evaluate specialized interventions for this subgroup of severely impaired youth.