The association between somatic complaints and past-30 day opioid misuse among justice-involved children.

Background: Individuals in the criminal justice system are especially vulnerable to the adverse effects of opioid misuse. Research on justice-involved children (JIC) is needed to uncover the variables that predict opioid misuse initiation to prevent misuse or reduce harm in this population. Somatic symptoms are symptoms experienced in the body, such as physical sensations, movements or experiences, which can cause severe distress and dysfunction. These include pain, nausea, dizziness, and fainting. In this study, we hypothesize that somatic complaints will be associated with a higher likelihood of opioid misuse among Florida JIC.

Methods: The study examined statewide data on 79,960 JIC in the Florida Department of Juvenile Justice database. Logistic regression was employed to investigate an ordinal measure of somatic complaints at first screen and a binary outcome measure of past-30 day illicit or nonmedical opioid use at final screen while controlling for sociodemographic and mental health factors.

Results: Nearly 28% of JIC had a history of one or more somatic complaints. Compared to those with no history of somatic complaints, JIC with a history of one or two somatic complaints were 1.23 times more likely to misuse opioids in the past 30 days and those with three or four somatic complaints were 1.5 times more likely to meet criteria for past-30 day opioid misuse.

Conclusions: Individuals may consume illicit or non-medical prescription opioids to manage somatic symptoms - indicating that increased access to healthcare may reduce misuse. Risk of opioid overdose sharply increases as justice-involved individuals are released from correctional settings largely due to a reduced tolerance to opioids as a result of incarceration and diminished access to legal medicines that are provided in the justice system. Justice systems must ensure seamless access to quality healthcare services as individuals transition from correctional settings to their communities.