Researchers have identified many risk factors for opioid misuse — including some that can be modified. A Canadian study of Ontario and Alberta secondary students examined the risks for misusing three types of prescription opioids: oxycodone, fentanyl and/or others (which included codeine, morphine and Tylenol #3). Use of other substances was a particularly potent risk factor. Binge drinking, mixing alcohol and energy drinks, using cannabis, vaping and smoking cigarettes resulted in 39% to 511% higher odds of misusing prescription opioids.

School experiences also influenced risk. Skipping classes, failing to complete homework (often or usually) and viewing school as very unsupportive in helping students resist or quit substances resulted in 41% to 358% higher odds of misusing opioids. As well, the availability of spending money from allowances or part-time employment was associated with 38% to 56% higher odds of misusing codeine, morphine and/or Tylenol #3.

An American study assessed the impact of another potential risk factor — adverse childhood experiences. To understand these experiences, researchers surveyed more than 10,500 public middle- and high-school students in Ohio, asking about 10 forms of adversity. These included emotional, physical and/or sexual abuse; physical and/or emotional neglect; witnessing intimate partner violence; living with someone who had substance use problems, had a mental illness or was incarcerated; and parental separation or divorce. All were linked with youth opioid misuse. Sexual abuse produced the greatest risk, with 6.8 times increased odds of opioid misuse. As well, experiencing multiple or cumulative adverse experiences greatly increased the odds. Young people with five or more of these negative early experiences had more than 15 times increased odds of misusing opioids.

For more information, see Vol. 18, No. 2 of the Children’s Mental Health Research Quarterly.