Non-medical opioid (NMO) use in Canadian adolescents: Trends, risk factors, and regional variations

Non-medical opioid (NMO) use is a serious issue among Canadian adolescents. Previous research has mainly focused on increases in opioid disorders and opioid-related mortality, while a focus on NMO use has been limited. Therefore, this study aims to examine how the reported NMO use changed over time among Canadian adolescents, focusing on three types of opioids: oxycodone, fentanyl, and other opioids (such as morphine, codeine, Tylenol #3). Additionally, this study will investigate demographic correlates of reported NMO use, including province of residence, age, Indigenous identity, sex, and urban/rural location.

Canadian Student Tobacco, Alcohol, and Drugs Survey data (2014-2015, 2016-2017, 2018-2019, and 2021-2022) were used. Adjusted logistic regression analyses, accounting for changes in respondent demographics, were conducted.

Overall adolescent reported past 12-month NMO use increased (2.5-3.2%) between 2014-2015 and 2021-2022. Specifically, past 12-month non-medical use of oxycodone (1.0-1.4%) and fentanyl (0.4-0.9%) increased over the study period, while use of other opioids declined slightly by 0.2% between 2018-2019 and 2021-2022. However, adjusted logistic regression analyses indicated that the odds of oxycodone use decreased between 2018-2019 and 2021-2022 (AOR = 0.88; 95% CI 0.86-0.90), whereas fentanyl use showed no significant change (AOR = 1.01; 95% CI 0.99-1.04). High school students, Indigenous-identifying, rural adolescents, and those in Alberta, Manitoba, and Quebec were particularly at higher odds.

These findings call for continued efforts to regulate and prevent NMO use, especially among adolescents who are more likely to engage in such behaviours.