In a nationally representative cross-sectional study of 15 200 parent-adolescent dyads from the National Survey on Drug Use and Health, controlling for other factors, parental medical prescription opioid use within the past year was associated with adolescent medical prescription opioid use and misuse, whereas parental misuse was not. These findings suggest that reducing opioid prescribing by physicians and educating families about medication use practices that restrict the availability of prescription opioids to adolescents in the home could be important targets for reducing adolescent prescription opioid misuse.
Screening for parental prescription opioid use could be part of pediatric practice. Addressing adolescent mental health could also reduce adolescent prescription opioid misuse.
Conclusions
This cross-sectional study is based on nationally representative dyadic samples of parent and adolescent offspring and distinguishes whether parental prescription opioid use or misuse drives the association between parent and offspring prescription opioid use. It documents the association of environmental familial factors with adolescent prescription opioid use. We found that parental medical prescription opioid use was associated with adolescent medical prescription opioid use and misuse, whereas parental misuse was not associated with either. The findings suggest several targets for preventing adolescent prescription opioid misuse. Reducing the availability of prescription opioids in the household and potential for diversion is essential. Strategies could include limiting opioid prescribing to parents, patient educational programs emphasizing the risks of parental opioid medications to their children, and guidelines for medication use practices, including safe storage and disposal, the use of lock boxes, and collection of leftover medications.8,50–52 Assessment of parental use of medically prescribed opioids could be part of pediatric practice. Nonopioid and nonpharmacological interventions (eg, psychological and behavioral) could be preferred for treating chronic pain.53 Prevention efforts could also target adolescent mental health, particularly depression. Although biological factors may also contribute to the association between parent and child prescription opioid use, the study suggests that structural and environmental factors are crucial contributing factors.
