Forecasting Opioid Use Disorder at 25 Years of Age in 16-Year Old Adolescents

People who, at 16, have a positive family history of substance abuse and are currently using addictive substances are very likely to develop a substance abuse disorder by age 25. Obvious but also important to remember when seeing adolescents for other reasons because addiction is really hard to cure and a major impediment to a long and happy life. James W. Mold, MD, MPH

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Objective

t To evaluate the accuracy of detecting 16 year old male (N=465) and female (N=162) youths who subsequently manifest opioid use disorder (OUD) at 25 years of age. We hypothesized that the combined measures of two components of etiology, heritable risk and substance use, accurately detect youths who develop OUD.

Study design

Heritable risk was measured by the transmissible liability index (TLI). Severity of the prodrome presaging OUD was quantified by the revised Drug Use Screening Inventory (DUSI-R) containing the consumption frequency index (CFI) documenting substance use events during the past month and the overall problem density (OPD) score indicating co-occurring biopsychosocial problems. Diagnosis of OUD was formulated by a clinical committee based on results of the Structured Clinical Interview for DSM-IV in conjunction with medical and social history records.

Results

Bivariate analysis shows that the TLI, CFI, and OPD scores at 16 years of age predict OUD at 25 years. Multivariate modeling indicates that the TLI combined with the CFI predict OUD with 86% accuracy (sensitivity = 87%; specificity = 62%). The TLI and CFI at 16 years of age mediate the association between parental substance use disorder and OUD in offspring at 25 years of age, indicating that these measures respectively evaluate risk and prodrome.

Conclusion

These results demonstrate the feasibility of identifying youths requiring intervention to prevent OUD.

Author/s:

Tarter, R.E., Kirisci, L., Reynolds, M., Seybert, A., Cochran, C., Vanyukov, M.