Texas Health Steps

Opioid Use Among U.S. Adolescents

While youth substance misuse has declined in recent years “substance use, including misuse of prescription opioids, remains common among U.S. high school students” (Centers for Disease Control and Prevention [CDC], 2020).

One in 7 U.S. high school students (14.3 percent) report misusing prescription opioids at least once. And 1 in 14 (7.2 percent) report current misuse of prescription opioids.

Female high school students report misuse of prescription opioids more often than male students. One in every 6 female high school students (16.1 percent) report misusing prescription opioids at least once, compared with one in every 8 male students (12.4 percent). And 1 in every 12 female students (8.3 percent) report current misuse of prescription opioids, compared with one in every 16 (6.3 percent) male students.

Among high school students who reported misusing prescription opioids in the previous 30 days:

  • 9.8 percent reported misuse 40 or more times
  • 13.7 percent reported misuse 10-39 times
  • 23.3 percent reported misuse 3-9 times
  • 53.2 percent reported misuse 1-2 times

High school students reporting current misuse of prescription opioids commonly reported use of the following other substances:

  • 43.5 percent reported current marijuana use
  • 59.4 percent reported current alcohol use
  • 30.3 percent reported current binge drinking

High school students who identify as lesbian, gay or bisexual are more likely to report current misuse of prescription opioids than students who identify as heterosexual.

High school students who are Black or Hispanic reported higher rates of current misuse of prescription opioids than students who are White.

Opioid prescriptions quadrupled in the United States between 1999 and 2010. As opioid use became more prevalent, pediatric exposure to these drugs increased (Rose, 2017).

Pain is one of the most common reasons individuals in the United States seek health care. Among those individuals seeking pain relief, 20 percent are prescribed opioid analgesics (Ibid.).

Eighty percent of the opioid prescriptions worldwide are distributed in the United States (Ibid.).

Nationwide, the overall opioid dispensing rate peaked in 2012 at more than 225 million total prescriptions, with 81.3 prescriptions per 100 individuals. By 2018, the U.S. opioid dispensing rate had dropped to 168 million total prescriptions, or 51.4 prescriptions per 100 individuals (CDC, 2020).

Even low levels of opioid exposure can have life-threatening effects for young people.


Source: 2019 Youth Risk Behavior Survey (CDC, 2020)

The Texas Perspective

In 2019, 16.6 percent of Texas high school students reported taking prescription pain medicine without a prescription at least once. Reported use for specific subgroups includes:

bar graph

Reported heroin use is low among Texas high school students, with only 1.3 percent of Texas high school students reporting using heroin in 2019. The rate of heroin use among Texas high school students has not changed significantly since 2014.

Source: Texas Youth Risk Behavior Survey (YRBS), 2019

Maternal opioid use

Opioid overdose is a leading cause of maternal death in Texas. In addition, the state’s rate of neonatal abstinence syndrome (NAS)—often caused by the mother’s use of opioids during pregnancy—nearly doubled from 2008 to 2017, jumping from 1.3 cases per 1,000 hospital births to 2.5 cases per 1,000 hospital births.

Source: Addressing Substance Use in Texas: Public Health Agency Action Plan 2020-2022, Texas Health and Human Services Commission & Texas Department of State Health Services, 2020