The prevalence of adolescent opioid use and dependence is increasing. The epidemiology of opioid use among youth in the 21st century raises concern over the potential far-reaching impact of prescription opioid and heroin use on the current generation of adolescents. In 2007, 232 000 adolescents reported misuse of just one of the many forms of prescription opioids, sustained-release oxycodone.1 During the same year, heroin, the opioid that is most often associated with “illicit” use, was used by 24 000 adolescents.1 The prevalence of hydrocodone use is reported to be 3% among 8th graders, 7% in 10th graders, and 10% in 12th graders.2 Most adolescent users report chewing, swallowing, or insufflating (snorting) opioids, although injection use is reported by 45% of users.3
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