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

Abstract

Adolescent opioid misuse is a public health crisis, particularly among clinical populations of youth with substance misuse histories. Given the negative and often lethal consequences associated with opioid misuse among adolescents, it is essential to identify the risk and protective factors underlying early opioid misuse to inform targeted prevention efforts. Understanding the role of parental risk and protective factors is particularly paramount during the developmental stage of adolescence. Using a social-ecological framework, this study explored the associations between individual, peer, family, community, and school-level risk and protective factors and opioid use among adolescents with histories of substance use disorders (SUDs). Further, we explored the potential moderating role of poor parental monitoring in the associations between the aforementioned risk and protective factors and adolescent opioid use. Participants included 294 adolescents (Mage = 16 years; 45% female) who were recently discharged from substance use treatment, and their parents (n = 323). Results indicated that lifetime opioid use was significantly more likely among adolescents endorsing antisocial traits and those whose parents reported histories of substance abuse. Additionally, adolescents reporting more perceived availability of substances were significantly more likely to report lifetime opioid use compared to those reporting lower perceived availability of substances. Results did not indicate any significant moderation effects of parental monitoring on any associations between risk factors and lifetime opioid use. Findings generally did not support social-ecological indicators of opioid use in this high-risk population of adolescents, signaling that the social-ecological variables tested may not be salient risk factors among adolescents with SUD histories. We discuss these findings in terms of continuing care options for adolescents with SUD histories that target adolescents’ antisocial traits, perceived availability of substances, and parent histories of substance abuse, including practical implications for working with families of adolescents with SUD histories.

Opioids and Youth Athletes

“…58 Risk factors for developing OUD in a vulnerable adolescent include perceived availability of opioids, antisocial traits, and parental history of substance misuse. 57,58 Navigating OUD is daunting, but there are effective evidence-based treatment options available including methadone, buprenorphine, and naltrexone. Unfortunately, a large systematic review found that adolescents are less likely to access these treatments than adults.…”

Perspectives of researchers with lived experience in implementation science research: Opportunities to close the research-to-practice gap in substance use systems of care

“…RLE have a unique lens through which they understand the complicated systems and interactions that people with substance use histories encounter while also having formal academic training in implementation science. From a lifespan perspective, the experiences of RLE may include interactions with multiple systems of care, such as child welfare, juvenile justice, educational settings, specialty treatment centers, aftercare settings, supportive housing, corrections, hospitals, and clinics ( Bronfenbrenner, 1979 ; Nargiso et al, 2015 ; Nichols et al, 2021 ). Lived interactions with these systems enhance collaborations with community partners and may advance the identification of potential barriers and elements of social and structural stigma that might otherwise go unnoticed ( Ahern et al, 2007 ; Morgan et al, 2015 ; van Boekel et al, 2013 ).…”

MedSMA℞T Adventures in PharmaCity Game: Youth Experiences and Recommendation for Use in Opioid Safety Education

“…Over 50% of adolescents who completed the Drug-Free America survey stated that it was easier to obtain these drugs from a medicine cabinet in their family's house than to receive illegal drugs from dealers [19]. Parents who are unaware of safe storage and disposal practice model unsafe behaviors in the home [20,21]. Coupled with youths' misunderstandings about opioids, it is critical to design novel interventions that are tailored to and target adolescents.…”