Monitoring the Future, a nationally representative cross-sectional survey of high school students, has collected data from high school seniors for >40 years.1 In this issue of Pediatrics, McCabe et al2 report findings on changes over time in medical and nonmedical use of prescribed opiates among high school seniors.2 This research is important because nonmedical use of prescribed opiates (NUPO) is believed to be a major cause of morbidity and mortality associated with opiates.3 

The consistency of the Monitoring the Future survey provides a high-level view of opiate use across the country from 1975 to 2015. Although helpful, this perspective can obscure critically important changes in local areas or within specific populations.

As might be expected, the study found that NUPO correlated with opioid prescriptions at yearly evaluations over the 40 years. The study also found that although women received more prescription opiates, the incidence of NUPO...

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