Examining Rural/Urban Differences in Prescription Opioid Misuse Among US Adolescents

PURPOSE: This study examines differences in prescription opioid misuse (POM) among adolescents in rural, small urban, and large urban areas of the United States and identifies several individual, social, and community risk factors contributing to those differences. METHODS: We used nationally repres...

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Bibliographic Details
Published inThe Journal of rural health Vol. 32; no. 2; pp. 204 - 218
Main Authors Monnat, Shannon M., Rigg, Khary K.
Format Journal Article
LanguageEnglish
Published England Journal of Rural Health 01.03.2016
Blackwell Publishing Ltd
Wiley Subscription Services, Inc
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Summary:PURPOSE: This study examines differences in prescription opioid misuse (POM) among adolescents in rural, small urban, and large urban areas of the United States and identifies several individual, social, and community risk factors contributing to those differences. METHODS: We used nationally representative data from the 2011 and 2012 National Survey on Drug Use and Health and estimated binary logistic regression and formal mediation models to assess past‐year POM among 32,036 adolescents aged 12‐17. RESULTS: Among adolescents, 6.8% of rural, 6.0% of small urban, and 5.3% of large urban engaged in past‐year POM. Net of multiple risk and protective factors, rural adolescents have 35% greater odds and small urban adolescents have 21% greater odds of past‐year POM compared to large urban adolescents. The difference between rural and small urban adolescents was not significant. Criminal activity, lower perceived substance use risk, and greater use of emergency medical treatment partially contribute to higher odds among rural adolescents, but they are also partially buffered by less peer substance use, less illicit drug access, and stronger religious beliefs. CONCLUSIONS: Researchers, policy makers, and treatment providers must consider the complex array of individual, social, and community risk and protective factors to understand rural/urban differences in adolescent POM. Potential points of intervention to prevent POM in general and reduce rural disparities include early education about addiction risks, use of family drug courts to link criminal offenders to treatment, and access to nonemergency medical services to reduce rural residents’ reliance on emergency departments where opioid prescribing is more likely.
Bibliography:http://dx.doi.org/10.1111/jrh.12141
National Institute of Child Health and Human Development - No. R24-HD041025
istex:AA7CEC82A26F4F90787BB2B4C1071AFB1737B560
Robert Wood Johnson Foundation New Connections Junior Investigators Program - No. 2014-2016
ArticleID:JRH12141
ark:/67375/WNG-F5XGTJV2-B
Population Research Institute at Penn State
Dr. Monnat acknowledges support from the Population Research Institute at Penn State which receives core funding from the National Institute of Child Health and Human Development (Grant R24‐HD041025). Dr. Monnat is also a current grantee (2014‐2016) with the Robert Wood Johnson Foundation New Connections Junior Investigators Program.
Disclosures
Everyone who has contributed to this study has been acknowledged herein. The authors do not have any potential, perceived, or real conflicts of interests. No honorarium, grant, or other form of payment was given to anyone to produce this article. Funders played no role in the study design, collection, analysis, or interpretation of the data or the decision to submit this article for publication.
Funding
ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:0890-765X
1748-0361
DOI:10.1111/jrh.12141