The multidimensional social ecological needs and service utilization patterns of youth using non-medical prescription opioids: an observational study of routinely collected data in a provincial integrated youth services initiative.

BACKGROUND: The present study aimed to identify opportunities for earlier intervention of non-medical prescription opioid use (NMPOU) among youth (aged 12-24) by characterizing the multidimensional social ecological needs of youth reporting NMPOU and their service utilization patterns in an expanding integrated youth services network. METHODS: The sample (n = 6181) included youth who accessed a novel integrated youth services (IYS) network in British Columbia, Canada, which delivers five core service streams for youth health and well-being through coordinated services. Analyses were conducted on routinely collected data drawn from youths' self-reported demographic and health measures and service provider-reported service utilization data. Multivariable logistic regression identified factors associated with past 30-day NMPOU and multivariable Poisson regression was used to compare service utilization outcomes between youth with and without NMPOU. RESULTS: A total of 248 (4%) youth reported past 30-day NMPOU. Multidimensional factors independently associated with NMPOU included poor self-rated physical health compared to excellent/very good physical health (adjusted odds ratio (aOR) = 2.51, 95% Confidence Interval (95% CI) = 1.39, 4.56), high likelihood of externalizing mental health disorders compared to low likelihood (aOR = 1.72, 95% CI = 1.03, 2.86), past 30-day illicit polydrug use compared to none (aOR = 10.00, 95% CI = 5.89, 16.99), and past 3-month exposure to violence compared to none (aOR = 2.18, 95% CI = 1.62, 2.92). Rates of service utilization were similar between youth with and without NMPOU (adjusted relative rate = 1.02, 95% CI = 0.95, 1.32). CONCLUSIONS: These findings indicate that youth with NMPOU present to IYS with several individual, interpersonal, and community-related social ecological needs. Integrated care models may be beneficial to address these multidimensional needs and reduce barriers to service utilization, thereby providing opportunity for earlier intervention of NMPOU among youth. Future research should examine the extent to which IYS reduce the incidence of NMPOU and improve opioid-related health and social outcomes among youth.