Abstract
Limited information is available regarding the association between parental and adolescent medical prescription opioid use and misuse in the US. To examine the associations between parental and adolescent prescription opioid medical use and misuse. This cross-sectional, nationally representative study included 15 200 parent-adolescent dyads from the annual 2015-2017 National Survey on Drug Use and Health. Data were collected from January 6, 2015, to December 20, 2017, and analyzed from October 4, 2019, to October 15, 2020. Parental past 12-month exclusive medical prescription opioid use and any misuse (ie, using without a prescription or in any way not directed by a physician). Adolescent past 12-month medical prescription opioid use or misuse. Multivariable regressions estimated associations between parental and offspring medical prescription opioid use or misuse, controlling for sociodemographic and psychosocial variables. Respondents included 9400 mother-child and 5800 father-child dyads in the same household; children were aged 12 to 17 years (52.8% male; mean [SD] age, 14.5 [1.7] years). Controlling for other factors, parental medical prescription opioid use was associated with adolescent prescription opioid medical use (adjusted odds ratio [aOR], 1.28; 95% CI, 1.06-1.53) and misuse (aOR, 1.53; 95% CI, 1.07-2.25), whereas parental misuse was not. Parental medical prescription stimulant use was associated with adolescent medical prescription opioid use (aOR, 1.40; 95% CI, 1.02-1.91). Parental marijuana use (aOR, 1.84; 95% CI, 1.13-2.99), parent-adolescent conflict (aOR, 1.26; 95% CI, 1.05-1.52), and adolescent depression (aOR, 1.75; 95% CI, 1.26-2.44) were associated with adolescent prescription opioid misuse. Adolescent delinquency (aOR, 1.55; 95% CI, 1.38-1.74) and perceived schoolmates' drug use (aOR, 2.87; 95% CI, 1.95-4.23) were also associated with adolescent misuse and more weakly with medical use (aORs, 1.13 [95% CI, 1.05-1.22] and 1.61 [95% CI, 1.32-1.96], respectively). Youth use of prescription opioids is in part a structural/environmental issue. The findings of this study suggest that parental medical prescription opioid use is associated with offspring prescription opioid use, whereas parental misuse is not. Restricting physicians' opioid prescribing to parents is a crucial public health goal. In addition, parents could be educated on the risks of their prescription opioid use for offspring and on practices to mitigate risk, including safe medication storage and disposal. Screening for parental prescription opioid use could be part of pediatric practice. Addressing adolescent mental health could also reduce adolescent prescription opioid misuse.
Highlights
Parental smoking and alcohol and marijuana use are associated with increased use of the same drug by offspring,[1,2,3,4] as is prescription opioid misuse.[5]
Controlling for other factors, parental medical prescription opioid use was associated with adolescent prescription opioid medical use and misuse, whereas parental misuse was not
Parental medical prescription stimulant use was associated with adolescent medical prescription opioid use
Summary
Parental smoking and alcohol and marijuana use are associated with increased use of the same drug by offspring,[1,2,3,4] as is prescription opioid misuse.[5]. Exposure to family members’ opioid prescriptions is associated with increased initiation of prescription opioid use among family members,[6] persistent opioid use after surgery among youths,[7] and opioid overdoses among youths who had not been prescribed opioids, especially at high dosages.[6,7,8,9,10] The family member’s relationship to the study populations is not specified except for mothers in one study[9] and parents in another.[7] These studies do not inform on the specific role of parental prescription opioid medical use and misuse in adolescent misuse or on parental and adolescent characteristics that could account for youth misuse. Unused medications create opportunities for nonprescribed use and drug sharing among friends and family members, who may perceive these medications to be low risk given their storage at home.” Almost 50% of adolescents who misuse prescription opioids report getting them from friends or relatives.[11]
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