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For Teens, Opioid Abuse Begins At Home

Parental use of non-medical opioids was a strong predictor of opioid use by their adolescent children, researchers found.

In a sample of 35,000 parent-child pairs, parental non-medical prescription opioid use was independently associated with lifetime use in their adolescent children ages 12 to 17 (adjusted OR 1.30, 95% CI 1.09-1.56), reported Denise Kandel, PhD, of the Columbia University Mailman School of Public Health in New York City, and colleagues.

Moreover, maternal non-medical prescription opioid use was significantly associated with use by both adolescent boys and girls (aOR 1.62, 95% CI 1.28–2.05), but the same association was not found for fathers, the authors wrote in Pediatrics.

“Everyone wants to reduce the risk of opioids and when you reduce the use of opioids among adults it also has the effect of reducing drugs among young people,” Kandel told MedPage Today. “If you ask people who misuse opioids where they got the opioids, a high proportion say they got it from a relative, a friend, or a medicine cabinet in the house.”

Sharon Levy, MD, MPH, of Boston Children’s Hospital, who was not involved in this study, said similar links between parents and their children have been found for substance use and other drugs. What still requires further examination, she said, is the role prescription medical use may play in this downstream parent-child association.

“We know when kids are prescribed medications they’re more likely to misuse them and go on to have an opioid misuse disorder,” Levy told MedPage Today. “But what is the relationship between your brother getting a prescription, or your parent, or anyone else who lives with you?”

Kandel and colleagues examined data from 21,200 mother-child and 13,800 father-child pairs from the 2004-2012 National Surveys on Drug Use and Health. Lifetime use was measured by asking participants whether they used 21 pain relievers they were not prescribed “for the experience or feeling it caused.” Researchers also asked if participants had ever smoked a cigarette, drank an alcoholic beverage, used marijuana or hashish “even once,” or used any other illicit drugs.

The 35,000 parents included were a mean age of 43.4, about 57% were women, and almost 80% were married. Adolescents were a mean age of 14.5, about 48% were girls, and 60% were white. Overall, the dyads in this sample were similar to nationwide statistics, indicating this sample was nationally representative, the authors reported.

About 14% of parents used a non-medical prescription opioid in their lifetime, with fathers and white parents having slightly higher rates of use than mothers or other races or ethnicities. Meanwhile, 9% of adolescents reported non-medical prescription opioid use, researchers said.

Lifelong parental smoking was a risk factor for adolescent use (aOR 1.24, 95% CI 1.02–1.51), as well as low levels of parental monitoring (aOR 1.21, 95% CI 1.12–1.31) and frequent conflicts (aOR 1.19, 95% CI 1.10–1.29).

Additionally, if children had already started smoking tobacco (aOR 1.37, 95% CI 1.14–1.65) or marijuana (aOR 1.25, 95% CI 1.02–1.53), they were more likely to use non-medical prescription opioids in their lifetime as well.

Finally, children were more likely to use non-medical prescription opioids if they were depressed (aOR 1.62; 95% CI 1.37–1.93), delinquent (aOR 1.50; 95% CI 1.42–1.59), or thought their classmates used drugs (aOR 1.71; 95% CI 1.44–2.04) as well.

The authors noted that this study is limited because the data are cross-sectional. Only one parent and child were assessed per household and researchers were unable to obtain information regarding prescription opioid use. Lastly, it is possible that children’s non-prescription opioid use could influence certain risk factors detected in this study, such as parent-child conflict, they said.

This study was funded by the National Institutes of Health.

Kandel was supported by the National Institute on Drug Abuse and she and co-authors were also supported by the New York State Psychiatric Institute.


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