Association between Non-Medical Use of Prescription Drugs and Emotional and Behavioral Problems among Chinese Adolescents: The Mediating Effects of Social Support

Abstract

Background Less is known about the underlying role of social support in the association between non-medical use of prescription drugs (NUMPD) and emotional and behavioral Problems (EBPs). This study sought to explore association among NMUPD, social support and EBPs in Chinese youth. Methods A multi-stage, stratified-cluster, random-sampling method was utilized to invite 23,364 adolescents aged 10–21 years from Guangdong province to complete standard questionnaires. Data on EBPs and social support were collected using the Strengths and Difficulties Questionnaire (SDQ) and the Adolescent Social Support Scale. Results The reported prevalence of sedative misuse, opioid misuse and any prescription drug use (APDU) was 1.3%, 0.4% and 1.5%, respectively. Multivariable linear regression models showed that non-medical use of opioid (adjusted β estimate = 2.06, 95%CI = 1.53–2.60), sedative (adjusted β estimate = 2.15, 95%CI = 1.20–3.09) and APDU (adjusted β estimate = 1.89, 95%CI = 1.40–2.37) maintained a positive association with total difficulties. Mediation analyses showed that the standardized indirect effects of NMUPD on total difficulties mediated by social support had statistical significance (P < 0.001) and mediating effect was between 14.75% and 27.50%. Conclusions Significant associations exist between NMUPD and EBPs. Social support significantly mediated association between NMUPD and EBPs. Drug abuse monitoring system targeted at adolescents could be established and social support from parents, teachers and peers are highly recommended to facilitate the mental health of adolescents.