Prescription opioid misuse among adolescents and emerging adults in the United States: A scoping review

Social-Ecological Predictors of Opioid Use Among Adolescents With Histories of Substance Use Disorders

“…Extending from the social-ecological model, prior empirical research has found strong evidence for diverse ecological factors predictive of substance use and other related behaviors in adolescence across diverse populations (Arthur et al, 2002;Bränström et al, 2008;Cleveland et al, 2008;Hemphill et al, 2011). Among individual-level predictors, prior tobacco, marijuana, and alcohol use have been consistently identified as salient indicators for subsequent opioid misuse among the general adolescent population (Sung et al, 2005;Back et al, 2010;Palamar et al, 2015;Vaughn et al, 2016;Barnett et al, 2019;Griesler et al, 2019;Bhatia et al, 2020;Bonar et al, 2020;Osborne et al, 2020). Specifically, the odds of reporting having ever misused opioids were three times higher among adolescents with histories of alcohol use (vs. those without), and two times higher among those with histories of cigarette and marijuana use (vs. those without; Barnett et al, 2019).…”

“…Specifically, the odds of reporting having ever misused opioids were three times higher among adolescents with histories of alcohol use (vs. those without), and two times higher among those with histories of cigarette and marijuana use (vs. those without; Barnett et al, 2019). Additionally, specific mental health concerns, such as depression and anxiety (Schepis and Krishnan-Sarin, 2008;Young A.M. et al, 2012;Edlund et al, 2015;Monnat and Rigg, 2016;Chan and Marsack-Topolewski, 2019;Griesler et al, 2019;Bonar et al, 2020); post-traumatic stress (McCauley et al, 2010;Mackesy-Amiti et al, 2015); and antisocial behavior (Sung et al, 2005;McCauley et al, 2010;McCabe et al, 2012;Young A.M. et al, 2012;Edlund et al, 2015;Nargiso et al, 2015;Vaughn et al, 2016;Bonar et al, 2020) were associated with increased likelihood of adolescent self-reports of opioid misuse.…”

“…Although the influence of peers on substance use increases during adolescence, the role of parenting continues to serve as a salient factor in predicting adolescent substance use involvement. Parenting factors, including poor parental monitoring, lack of parental involvement, parental histories of substance use, and tolerant parental attitudes toward substance use are associated with adolescent substance use, including opioid misuse (Sung et al, 2005;Gilson and Kreis, 2009;Donaldson et al, 2015;Edlund et al, 2015;Nargiso et al, 2015;Vaughn et al, 2016;Griesler et al, 2019;Bonar et al, 2020). Although peers and parents serve as important risk and protective factors, prior research has documented complex interactions between peer associations and parental monitoring, such that the substance use risk associated with peers may be magnified when adolescents experience low levels of parental monitoring (Kiesner et al, 2010).…”

“…Prior research has also identified several influential school and community-level (i.e., exosystem) risk factors for adolescent opioid misuse. Relevant school-level risk factors include academic achievement (Young A.M. et al, 2012;Veliz et al, 2013;Nargiso et al, 2015;Vaughn et al, 2016;Schepis et al, 2018;Barnett et al, 2019;Bonar et al, 2020) as well as school bonding and negative attitudes toward school (Ford, 2009;Young A.M. et al, 2012;Ford and Rigg, 2015;Nargiso et al, 2015;Nicholson et al, 2016). In a systematic review of studies on youth non-medical prescription drug use, five of six studies assessing low academic performance, school dropout, or lack of school-bonding found a significantly higher prevalence of prescription drug use among youth with these risks (Young A.M. et al, 2012).…”

“…Despite the extensive body of evidence on risk and protective factors for adolescent opioid misuse, to date there has been limited evidence examining these associations in clinical samples of adolescents who may be at particularly high risk for opioid misuse (Bonar et al, 2020). Most prior research on this topic has analyzed data from large national surveys of U.S. adolescents, which can yield valuable insights on patterns in the general adolescent population; however, these findings may not be generalizable to high-risk adolescent subpopulations, such as those with SUDs.…”