Date of Award

12-1-2023

Language

English

Document Type

Master's Thesis

Degree Name

Master of Science (MS)

College/School/Department

Department of Epidemiology and Biostatistics

Dissertation/Thesis Chair

Melissa Tracy

Committee Members

Elizabeth Vasquez

Keywords

Opioid abuse, Opioid Misuse, Opioid misuse among Adolescents, Opioid misuse among High School, Prescription Opioid Misue, Sex/race patterns in opioid misuse

Subject Categories

Epidemiology

Abstract

Background: Drug overdose deaths in the U.S. have been increasing and are primarily related to opioid use. In 2019, an estimated 7.2% of US high school students reported misusing prescription opioids in the past 30 days. Prescription opioid misuse in adolescents may lead to development of a substance use disorder, overdose, or other serious harms. Some researchers have observed sex and race differences in prescription opioid use. This study aimed to identify patterns of prescription opioid misuse among adolescent subgroups categorized by both sex and race/ethnicity, to provide insight into intervention development and targeting.Methods: We analyzed data from the Youth Risk Behavior Survey (YRBS) conducted among high school students in the U.S. in 2019 and 2021. We created a 10-category sex/race variable to capture different combinations of youth sex and race/ethnicity. Our outcome variable was self-reported prescription opioid misuse in the past 30 days. We also considered other important risk factors for prescription opioid misuse, including smoking, alcohol use, illicit drug use, physical activity, and history of concussions. We assessed potential effect modification of the association between sex/race and prescription opioid misuse by depression status and alcohol consumption. Results: Overall, 6.53% of the YRBS sample in 2019-2021 reported prescription opioid misuse in the past 30 days. The prevalence was highest among non-Hispanic Black females (10.9%) and Hispanic females (11.2%). The unadjusted odds ratio for prescription opioid misuse among Hispanic/Latino females, is (OR= 2.05, 95% CI=1.45 to 2.90) and for non-Hispanic Black females, the unadjusted odds ratio for prescription opioid misuse (OR= 1.87, 95% CI =1.27 to 2.74) compared to Hispanic/Latino males. This pattern remained similar when adjusting for other risk factors, with significantly higher odds among non-Hispanic Black females (aOR=1.95, 95% CI =1.31 – 2.89) and Hispanic females (aOR= 1.64 95% CI =1.15 – 2.36), compared to Hispanic males. Depression and substance use behaviors were also significantly associated with prescription opioid misuse, with higher odds for students reporting feelings of depression (aOR=2.50, 95% CI =1.96 – 3.19), smoking (aOR=1.89, 95% CI =1.41 – 2.53), alcohol use (aOR=2.04, 95% CI =1.73 – 2.42) and illicit drug use (aOR= 3.45, 95% CI =2.90 – 4.10). Finally, reporting a concussion because of sports or physical activity in the past 12 months was also associated with higher odds of prescription opioid misuse in the past 30 days (aOR = 1.72, 95% CI = 1.36 – 2.18). Neither depression (p=0.111) nor alcohol use (p=0.477) modified the relation between sex/race/ethnicity and prescription opioid misuse. Conclusions: More than one in every ten Hispanic females and non-Hispanic Black females who participated in the YRBS in 2019-2021 reported recent prescription opioid misuse. Education and intervention strategies targeted to these specific groups are needed to prevent further harms resulting from prescription opioid misuse. Evaluating other confounders such as socioeconomic status and adverse childhood experiences can potentially further explain association.

Download

Included in

Epidemiology Commons

Share

COinS