Adolescents’ Understanding of Opioid-Induced Euphoria Measures and Proposed Measurement Revisions

ABSTRACT

Prescription opioid misuse is an unintended consequence of acute pain management. Opioid-induced euphoria (OIE) with first therapeutic opioid exposure may influence opioid misuse. OIE is not assessed in clinical care and self-report measures of OIE have not been validated in adolescents. We (1) determined adolescents’ ability to understand existing self-reported OIE measures, (2) revised measures for better understanding by this population, and (3) established initial content validity of revised measures with adolescents. Using runner’s euphoria to simulate OIE in Study 1, 29 adolescents’ (14 males) understanding of the Drug Effects Questionnaire (DEQ-5), the Addiction Resource Center Inventory Morphine Benzedrine Group scale (ARCI-MBG), and the ARCI Lysergic Acid Diethylamide scale (ARCI-LSD) were tested. In Study 2, 29 additional adolescents (9 males) participated in a modified Delphi study with focus groups to revise survey items to improve understanding by peers. In Study 1, runners understood <40% of ARCI-MBG and ARCI-LSD statements. In Study 2, all but 7 survey items were revised. Revised measures of OIE for adolescents may help define at-risk OIE phenotypes and validate risk assessments using survey methodology. Additional studies are needed to validate the revised OIE self-report measures with opioid-naive adolescents receiving opioids to treat acute pain.

KEYWORDS:

• Adolescents
• euphoria self-report
• opioid
• opioid-induced euphoria
• runner’s euphoria

Acknowledgments

The authors would like to thank Stacey Tobin for her editorial assistance.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplementary material

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Additional information

Funding

This work was supported by the Posey and Fred Love Endowed Chair of Nursing Research, Ann & Robert H. Lurie Children’s Hospital of Chicago. RedCapTM NUCATS is funded in part by a Clinical and Translational Science Award (CTSA) grant from the National Institutes of Health (NIH) [UL1TR001422].