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Opioid Use in Teens: Risks, Prevention, and Treatments

Elena Hill, MD, MPH profile image
Medically Reviewed By Elena Hill, MD, MPH • Updated Aug 13, 2023 • 6 cited sources

Opioid use disorder (OUD) in teenagers is less understood and often under-recognized and undertreated because it is a new and growing problem.

The risks of opioid dependence and misuse have increased in this age range in the past decades along with the overall rise in opioid misuse in the US.[1]

OUD in teens can often be treated with the same pharmacological options as adults.

Why Is Opioid Use Risky in Teens?

Opioids are dangerous for any age group, especially teens and young adults.

Researchers say using opioids legitimately (per a doctor’s prescription) is associated with a 33% increase in the risk of opioid misuse after high school.[2]

While the risks of opioid use in younger populations is still being studies, it is likely that certain variables put younger adults at greater risk if using opioids, such as:

Reduced Inhibition

Adolescent brains are changing, and parts of the brain associated with decision-making and control aren’t fully developed. Teenagers can’t always parse the risks and benefits involved with their decisions, and they’re more likely to be impulsive. Where an adult might quit using due to a more sophisticated sense of caution, an adolescent might not adequately gauge the risks.   

Enhanced Vulnerability

All opioids can cause feelings of pleasure and release. The adolescent brain is particularly attuned to these feelings as it is still developing, and may be more susceptible to the pleasant reward feelings induced by opioids. 

Risk of Overdose

Just like adults, teens who take too many opioids can depress their central nervous system, stop breathing, and die. In 2016, one death in five among young adults was related to opioids.[3]

3 Signs of Opioid Use You Should Know About

Every teenager is different, and some are more adept at hiding their drug use from their parents or guardians.  These are some signs concerned parents or guardians should look for: 

1. Missing Medications in the Home 

Teenagers get exposed to opioids the same way adults do, either legally or illegally. Adolescents often obtain and misuse opioid prescriptions belonging to friends or family members. This is a common way teens report their first exposure to opioids.

Adults should never offer opioid medications to their children without a prescription, even if they have an acute episode of pain or are just trying to be helpful.

Opioid medications should be kept locked or safe in the home. If you have a surplus from a prior prescription, you can dispose of an opioid by flushing it down the toilet. You could also take it to a healthcare facility or doctor’s office, where it can be disposed of safely. 

Losing Pills or Asking to See Other Doctors 

Most patients with OUD report that their first exposure to opioids was through a legal prescription. [5] Teens can also be prescribed opioids after dental work, for example.[4] One cohort study of over 189,000 youths given an initial opioid medication found that anywhere from 10% to 30% developed an OUD.[4]

If your child has a prescription for an opioid, make sure you keep an eye on how many they are taking. If they are a minor, you should be in charge of giving them this medication so you can keep track of how much they are taking. If their pain is resolved, make sure you throw out or return the remaining pills. 

Changing Priorities & Habits

Teenagers can naturally have mood swings or changes in behaviors for any number of reasons. However, severe or swift changes could be prompted by drug misuse. If your child displays any of the following changes in behavior, it might be worth checking in with them about what’s going on:

  • Stop spending time with family or friends
  • Get worse grades at school
  • Demand privacy and alone time 
  • Seem sedated and sleepy most of the time 
  • Stop paying attention to their appearance 

How to Talk With Your Teen About Opioid Misuse 

Whether you think your teen is using opioids now or you simply want to help prevent them from using in the future, conversations and communication are key. Parents have a profound influence over whether or not their kids use drugs.

Follow these tips from the Substance Abuse and Mental Health Services Administration:[3]

  • Choose an informal time to talk rather than scheduling a “serious discussion.” 
  • Set clear expectations about drug use and what will/will not be tolerated in your home. 
  • Let your child know that you care and are always available.
  • Create a messaging plan, so your child can reach out to you immediately if they find themselves in a situation where they are being pressured to use drugs. 
  • Ensure your child that they will not be punished if they reach out to you for help. Do not let fear of punishment or repercussions be the reason they keep their misuse clandestine. [6] 

How to Treat Teenagers With Opioid Use Disorder

The FDA has approved Suboxone as a treatment for OUD in patients 16 years and older.[1] Some providers may use Suboxone in children even younger in circumstances of extreme addiction, as necessary.

So far, the success rates of treating OUD with Suboxone in teenagers seem to be similar to those in adults.[1]

Overall, Suboxone is a safe and effective treatment of OUD in teenagers and young adults. Families with a teenager or youth struggling with OUD should consider swift, multifaceted interventions to prevent the progression of substance misuse. Suboxone can and should be a component of that intervention even for younger adults.

Photo by Warren Wong on Unsplash

Medically Reviewed By Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where ... Read More

  1. Buprenorphine Treatment for Adolescents and Young Adults with Opioid Use Disorders: A Narrative Review. Journal of Addiction Medicine. May 2018. Accessed August 2022.
  2. Prescription Opioids in Adolescence and Future Opioid Misuse. Pediatrics. November 2015. Accessed August 2022.
  3. Talking With Your Teen About Opioids. Substance Abuse and Mental Health Services Administration. 2020. Accessed August 2022.
  4. Trajectories of Opioid Use Following First Opioid Prescription in Opioid-Naïve Youths and Young Adults. JAMA. April 2021. Accessed August 2022.
  5. ED Prescription Opioids As An Initial Exposure Preceding Addiction. Annals of Emergency Medicine. August 2017. Accessed August 2022. 
  6. How to Talk to Your Kids About Prescription Drug Abuse. Aetna. Accessed August 2022.

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