Opioid misuse greatly increases chance of major depressive episode among teen girls

New research by Keith Chan of UAlbany's School of Social Welfare shows that among girls ages 12-17, the misuse of opioids greatly increases the chance of having a major depressive episode. Prescription opioids may include oxycodone, hydrocodone and fentanyl.

"Adolescent females were at a higher risk for poor mental health outcomes compared to adolescent males, and opioid misuse further heightened this risk," reported Chan in an article published earlier this month in the Child and Adolescent Social Work Journal. "Social workers in collaboration with other professionals can play a central role by coordinating substance use and mental health prevention and recovery services."

The study used data from the 2016 National Survey on Drug Use and Health and included 11,489 respondents ages 12 to 17. Adolescents and young adults are already a vulnerable population, as they have the highest prevalence of substance use and mental health disorders.

Christina Marsack-Topolewski, a co-author from Eastern Michigan University, noted that "although some adolescents may misuse opioids while simultaneously using other illicit substances, many opioid users may not fit the profile of the typical substance abuser."

In addition, 1 in 5 high school students were prescribed opioids by their senior year. Opioids may be prescribed for post-surgery recovery or dental work, such as wisdom tooth extraction. Some adolescents, as a result, may think opioids are safer than other substances. Those who have experienced depression before were at higher risk for opioid misuse and may misuse prescription opioids to self-medicate.

Although mortality rates from opioid misuse are higher among males, the rate is increasing faster for females.

Chan notes that suicide rates have trended up from 2000 to 2017 and are highest among adolescents, with an increasing trend among adolescent females. Adolescent females were at higher risk for depression, self-harming behaviors and thoughts of suicide than their male counterparts. While adolescent males were more likely to be diagnosed with childhood disorders such as attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder, female teens were more likely to report having a recent major depressive episode.

In light of his findings, Chan recommended that social workers conduct more comprehensive mental health screenings for adolescents, paying particular attention to females who have a past history of misuse or who may be currently misusing opioids.

There is a dire need for interprofessional collaborations, greater outreach and more mental health professionals who can effectively address prevention, treatment and recovery efforts for persons impacted by this growing epidemic."

Keith Chan, UAlbany's School of Social Welfare