Abstract
Prescription opioid misuse has become one of the most frequent types of drug consumption among adolescents. Our objective was to report the prevalence, gender differences, and factors associated with prescription opioid misuse in school-aged adolescents. An observational study was conducted. We used the Spanish State Survey on Drug Use in Secondary Education 2018–2019, which covers drug use among students aged 14–18 years. Based on logistic multivariate regression models, we estimated the independent effect of each variable on prescription opioid misuse. Prescription opioid misuse was reported by 554 adolescents, with a greater prevalence in boys than girls (OR = 2.72). Misuse of tranquilizers, sedatives, sleeping pills, and other illicit psychoactive drugs (AOR = 9.32) are risk factors for prescription opioid misuse in both genders. Use of cannabis (AOR = 3.23) and cocaine (AOR = 2.28) is the predictor of prescription opioid misuse in females. There are differences in risk factors for prescription opioid misuse by gender.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Barnett, T. E., Thompson, E. L., Litt, D. M., & Lewis, M. A. (2019). Correlates of nonmedical prescription opioid use among U.S. adolescents. American Journal of Preventive Medicine, 57(5), e175–e179. https://doi.org/10.1016/j.amepre.2019.05.006
Bonar, E. E., Coughlin, L., Roche, J. S., Philyaw-Kotov, M. L., Bixler, E. A., Sinelnikov, S., Kolosh, A., Cihak, M. J., Cunningham, R. M., & Walton, M. A. (2020). Prescription opioid misuse among adolescents and emerging adults in the United States: A scoping review. Preventive Medicine, 132, 105972. https://doi.org/10.1016/j.ypmed.2019.105972
Bosetti, C., Santucci, C., Radrezza, S., Erthal, J., Berterame, S., & Corli, O. (2019). Trends in the consumption of opioids for the treatment of severe pain in Europe, 1990–2016. European Journal of Pain (London, England), 23(4), 697–707. https://doi.org/10.1002/ejp.1337
Canadian Centre of Substance Use and Addiction. (2020). Prescription opioids. Canadian drug summary. Retrieved May 15, 2022, from https://www.ccsa.ca/prescription-opioids-canadian-drug-summary
Carmona, J., Maxwell, J. C., Park, J. Y., & Wu, L. T. (2020). Prevalence and health characteristics of prescription opioid use, misuse, and use disorders among U.S. adolescents. The Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine, 66(5), 536–544. https://doi.org/10.1016/j.jadohealth.2019.11.306
Caupp, S., Steffan, J., Shi, J., Wheeler, K. K., Spiller, H. A., Casavant, M. J., & Xiang, H. (2018). Opioid drug poisonings in Ohio adolescents and young adults, 2002–2014. Clinical toxicology (Philadelphia, Pa.), 56(8), 765–772. https://doi.org/10.1080/15563650.2018.1424889
Das, J. K., Salam, R. A., Arshad, A., Finkelstein, Y., & Bhutta, Z. A. (2016). Interventions for adolescent substance abuse: An overview of systematic reviews. The Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine, 59(4S), S61–S75. https://doi.org/10.1016/j.jadohealth.2016.06.021
ESPAD Group (2020). ESPAD Report 2019: Results from the European school survey project on alcohol and other drugs, EMCDDA Joint Publications, Luxembourg. Retrieved May 15, 2022, from https://www.emcdda.europa.eu/system/files/publications/13398/2020.3878_EN_04.pdf
European Monitoring Centre for Drugs and Drug Addiction (2019). European drug report 2019: Trends and developments, Publications Office of the European Union, Luxembourg. Retrieved May 15, 2022, from https://www.emcdda.europa.eu/system/files/publications/11364/20191724_TDAT19001ENN_PDF.pdf
Fernandez-Montalvo, J., Lopez-Goñi, J. J., Azanza, P., & Cacho, R. (2014). Gender differences in drug-addicted patients in a clinical treatment center of Spain. The American Journal on Addictions, 23(4), 399–406. https://doi.org/10.1111/j.1521-0391.2013.12117.x
Fotiou, A., Kanavou, E., Richardson, C., Ploumpidis, D., & Kokkevi, A. (2014). Misuse of prescription opioid analgesics among adolescents in Greece: The importance of peer use and past prescriptions. Drugs: Education Prevention and Policy, 21. https://doi.org/10.3109/09687637.2014.899989.
Grigsby, T. J., & Howard, J. T. (2019). Prescription opioid misuse and comorbid substance use: Past 30-day prevalence, correlates and co-occurring behavioral indicators in the 2016 National Survey on Drug Use and Health. The American Journal on Addictions, 28(2), 111–118. https://doi.org/10.1111/ajad.12866
Groenewald, C. B., Patel, K. V., Rabbitts, J. A., & Palermo, T. M. (2020). Correlates and motivations of prescription opioid use among adolescents 12 to 17 years of age in the United States. Pain, 161(4), 742–748. https://doi.org/10.1097/j.pain.0000000000001775
Häuser, W., Buchser, E., Finn, D. P., Dom, G., Fors, E., Heiskanen, T., Jarlbaek, L., Knaggs, R. D., Kosek, E., Krcevski-Škvarč, N., Pakkonen, K., Perrot, S., Trouvin, A. P., & Morlion, B. (2021). Is Europe also facing an opioid crisis?-A survey of European Pain Federation chapters. European Journal of Pain (London England), 25(8), 1760–1769. https://doi.org/10.1002/ejp.1786
Hosmer, D. W., Lemeshow, S., & Sturdivant, R. X. (2013). Applied logistic regression, 3rd Edition. Wiley.
Hudgins, J. D., Porter, J. J., Monuteaux, M. C., & Bourgeois, F. T. (2019). Prescription opioid use and misuse among adolescents and young adults in the United States: A national survey study. PLoS Medicine, 16(11), e1002922. https://doi.org/10.1371/journal.pmed.1002922
Jeanne, G., Purper-Ouakil, D., Rigole, H., & Franc, N. (2017). New patterns of substance use and abuse among French adolescents, a knowledge synthesis. L’Encephale, 43(4), 346–353. https://doi.org/10.1016/j.encep.2016.05.012
Johnson, R. M., Fairman, B., Gilreath, T., Xuan, Z., Rothman, E. F., Parnham, T., & Furr-Holden, C. D. (2015). Past 15-year trends in adolescent marijuana use: Differences by race/ethnicity and sex. Drug and Alcohol Dependence, 155, 8–15. https://doi.org/10.1016/j.drugalcdep.2015.08.025
Jones, C. M., Clayton, H. B., Deputy, N. P., Roehler, D. R., Ko, J. Y., Esser, M. B., Brookmeyer, K. A., & Hertz, M. F. (2020). Prescription opioid misuse and use of alcohol and other substances among high school students - Youth risk behavior survey, United States, 2019. MMWR Supplements, 69(1), 38–46. https://doi.org/10.15585/mmwr.su6901a5
Jordan, A. E., Blackburn, N. A., Jarlais, D., & Hagan, H. (2017). Past-year prevalence of prescription opioid misuse among those 11 to 30years of age in the United States: A systematic review and meta-analysis. Journal of Substance Abuse Treatment, 77, 31–37. https://doi.org/10.1016/j.jsat.2017.03.007
Kalkman, G. A., Kramers, C., van Dongen, R. T., van den Brink, W., & Schellekens, A. (2019). Trends in use and misuse of opioids in the Netherlands: a retrospective, multi-source database study. The Lancet Public Health, 4(10), e498–e505. https://doi.org/10.1016/S2468-2667(19)30128-8
Kimber, J., Hickman, M., Strang, J., Thomas, K., & Hutchinson, S. (2019). Rising opioid-related deaths in England and Scotland must be recognised as a public health crisis. The Lancet Psychiatry, 6(8), 639–640. https://doi.org/10.1016/S2215-0366(19)30209-3
McHugh, R. K., Nguyen, M. D., Chartoff, E. H., Sugarman, D. E., & Greenfield, S. F. (2021). Gender differences in the prevalence of heroin and opioid analgesic misuse in the United States, 2015–2019. Drug and Alcohol Dependence, 227, 108978. https://doi.org/10.1016/j.drugalcdep.2021.108978
Milani, S. A., Lloyd, S. L., Serdarevic, M., Cottler, L. B., & Striley, C. W. (2020). Gender differences in diversion among non-medical users of prescription opioids and sedatives. The American Journal of Drug and Alcohol Abuse, 46(3), 340–347. https://doi.org/10.1080/00952990.2019.1708086
Ministry of Health, Consumption and Social Welfare (2021). National plan on drugs. State Survey on Drug Use in Secondary Education (ESTUDES). Retrieved May 15, 2022, from https://pnsd.sanidad.gob.es/profesionales/sistemasInformacion/sistemaInformacion/encuestas_ESTUDES.htm
Muller, A. E., Clausen, T., Sjøgren, P., Odsbu, I., & Skurtveit, S. (2019). Prescribed opioid analgesic use developments in three Nordic countries, 2006–2017. Scandinavian Journal of Pain, 19(2), 345–353. https://doi.org/10.1515/sjpain-2018-0307
National Institute of Statistics (INE). Glossary. Glosario - INE://www.ine.es › Satellite › disca_ig_glo.pdf. Retrieved May 15 (2022). from https://www.ine.es/
Osborne, V., Serdarevic, M., Crooke, H., Striley, C., & Cottler, L. B. (2017). Non-medical opioid use in youth: Gender differences in risk factors and prevalence. Addictive Behaviors, 72, 114–119. https://doi.org/10.1016/j.addbeh.2017.03.024
Romo-Avilés, N. (2011). Cannabis, youth and gender: New patterns of use, new prevention models. Trastornos Adictivos, 13(3), 91–93.
Schepis, T. S., Teter, C. J., & McCabe, S. E. (2018). Prescription drug use, misuse and related substance use disorder symptoms vary by educational status and attainment in U.S. adolescents and young adults. Drug and Alcohol Dependence, 189, 172–177. https://doi.org/10.1016/j.drugalcdep.2018.05.017
Spanish Agency of Medicines and Health Products (2021). Use of opioid medications in Spain. Retrieved May 15, 2022, from https://www.aemps.gob.es/medicamentos-de-uso-humano/observatorio-de-uso-de-medicamentos/utilizacion-de-medicamentos-opioides-en-espana/
Springer, S. A., Biondi, B. E., Frank, C., & El-Bassel, N. (2020). A call to action to combat the opioid epidemic among women. Journal of Addiction Medicine, 14(5), 364–366. https://doi.org/10.1097/ADM.0000000000000622
Tuchman, E. (2010). Women and addiction: the importance of gender issues in substance abuse research. Journal of Addictive Diseases, 29(2), 127–138. https://doi.org/10.1080/10550881003684582
Voepel-Lewis, T., Boyd, C. J., McCabe, S. E., Zikmund-Fisher, B. J., Malviya, S., Grant, J., Weber, M., & Tait, A. R. (2018). Deliberative prescription opioid misuse among adolescents and emerging adults: Opportunities for targeted interventions. The Journal of Adolescent Health, 63(5), 594–600. https://doi.org/10.1016/j.jadohealth.2018.07.007
Funding
This work was supported by the Government Delegation for the National Plan on Drugs (Ministry of Health, Consumption and Social Welfare) (grant No.: 2020I056). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Author information
Authors and Affiliations
Contributions
PCG, DPC, CGP, IJT, LLF, SGGH, and VHB contributed to substantial contributions to the conception or design of the work, or the acquisition, analysis, or interpretation of data for the work. PCG, DPC, and CGP conceptualized and designed the study and methodology. IJT, LLF, and SGGH oversaw data and collection/study management. VHB and PCG conducted analyses and wrote the initial manuscript draft, with subsequent contributions from all authors. PCG and VHB received funding and provided administrative and technical support for the study. All authors contributed to paper revisions and have approved of the final version of the manuscript.
Corresponding author
Ethics declarations
Ethical Approval
This is an observational study. We did not require ethics committee approval, because the database provided by the Ministry of Health, Consumer Affairs and Social Welfare was anonymous and publicly available. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Consent to Participate
This is an observational study. We did not obtain consent to participate, because the database provided by the Ministry of Health, Consumer Affairs and Social Welfare was anonymous and publicly available.
Conflict of Interest
The authors declare no competing interests.
Standards of Reporting
The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement was used (https://www.equator-network.org/reporting-guidelines/strobe/).
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Carrasco-Garrido, P., Palacios-Ceña, D., Jiménez-Trujillo, I. et al. Prescription Opioid Misuse Among School-Aged Adolescents: Gender Differences and Related Factors. Int J Ment Health Addiction (2022). https://doi.org/10.1007/s11469-022-00954-3
Accepted:
Published:
DOI: https://doi.org/10.1007/s11469-022-00954-3