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US Adolescents' and Young Adults' Sources for Prescription Opioid Misuse: Age, Substance Use, and Mental Health
Ty S Schepis1,2, Brady T West2,3,4, Jason A Ford2,5
1Department of Psychology, Texas State University, San Marcos, Texas, USA.
Background:
Medication sources for prescription opioid misuse in US adolescents and young adults may have changed, particularly related to the COVID-19 pandemic. We examined how opioid sources vary across age groups and cohorts and whether links between sources and substance use or mental health vary between age groups.
Methods:
Cross sectional nationally representative survey data from the 2015-2019 and 2021-2022 National Survey on Drug Use and Health were used. Respondents were interviewed in their homes (2015-19) or via mixed household and web-based survey methods (2021-2022). Participants were 6045 14-25-year-old reporting past-year prescription opioid misuse. Mutually exclusive opioid sources were physicians, purchases, theft, and friends/family for free. Cross-tabulations estimated source prevalence by age, and logistic and negative binomial regression models evaluated links between sources (independent variable) and substance use, mental health, and sociodemographics (individual dependent variables).
Results:
Theft declined significantly with age in the 2015-2019 cohort (12.4% to 4.7%), with some evidence of opioid source differences between 2015-2019 and 2021-2022. Those using purchases had the most past-month prescription opioid misuse days and the highest prevalence of substance use disorder from misuse (e.g., 23.4% of 2015-2019 young adults), other substance use, and mental health concerns; those using theft typically had the second highest rates, with the lowest rates often in the physician source group.
Conclusion:
We found age- and cohort-based differences in sources, and mechanisms underlying these differences warrant further study. Adolescents and young adults using purchases or theft to obtain opioids are important targets for identification and intervention.
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