Understanding Differences in Prescription Painkiller Misuse among Adolescents in Large Urban, Small Urban, and Rural Areas

• In Event: 164 - Regular Session. Substance Use, Abuse, and Treatment

Abstract

Prescription painkiller (opioid) misuse (POM) is a major public health problem in the U.S. and has been occurring at a particularly high rate among adolescents. The purpose of this research was to examine differences in adolescent POM between large urban, small urban and rural areas of the U.S. and identify how social environments influence differences in POM across these spatial groups. Nationally representative data on 31,990 adolescents (aged 12-17) came from the 2011 and 2012 National Survey on Drug Use and Health. Binary logistic regression models were used to identify and explain differences in past year POM. We found 5.3% of adolescents in large urban, 6.0% in small urban and 6.6% in rural areas engaged in past-year POM. Lower socioeconomic status (SES) explained the higher likelihood of misuse among rural and small urban adolescents. Fully adjusted models revealed that rural and small urban adolescents experience a protective effect from their relatively less risky social environments (e.g., less drug access, less social network substance abuse). After accounting for these environments, adolescents in rural areas had 29% greater odds of POM, and adolescents in small urban areas had 20% greater odds of POM compared to those in large urban areas. This suggests the most effective interventions in rural and small urban areas should be focused on SES-related risk factors for POM, and the most effective interventions in large urban areas should be focused on decreasing access to opioids and other controlled substances.

Authors

• Shannon M. Monnat, Pennsylvania State University

• Khary K Rigg, University of South Florida