Researchers examine influence of peers and parents on adolescent prescription opioid use

A new University of Florida and East Carolina University study finds that peer approval or disapproval has a strong influence on whether or not adolescents engage in nonmedical use of prescription opioids. The findings appear in the journal Prevention Science.

“While there are a myriad of factors that may influence recreational or nonmedical use of prescription opioids among adolescents, we found an adolescent is more likely to engage in nonmedical use of prescription opioids if their same-age peers approve of this behavior,” said lead author Dr. Kathleen Egan, who conducted the research as a postdoctoral fellow in UF’s T32 training program in substance abuse.

Directed by Dr. Linda B. Cottler, the training program is funded by the National Institute on Drug Abuse and housed in the department of epidemiology in the UF College of Public Health and Health Professions and the College of Medicine.

“We also found that females who had parents who disapproved of nonmedical use of prescription opioids were less likely to report this behavior, but this was not true for males,” said Dr. Egan, now an assistant professor in the department of health education and promotion at East Carolina University’s College of Health and Human Performance.

For the study, Dr. Eric Gregory invited adolescents in grades six through 12 across 44 schools in south central Kentucky to participate in an anonymous, school-based survey. Nearly 12,000 students completed the survey, which asked questions about their own nonmedical prescription opioid use and their perceptions of peer and parent attitudes toward nonmedical prescription opioid use. Nearly 300 respondents reported nonmedical opioid use within the past year.

Dr. Egan said the team’s findings offer important insights for parents.

“When considering ways in which to protect your child from recreational use of prescription opioids, focus on your child’s friends,” she said. “Do you have reason to believe that they are likely to approve of or engage in recreational use of prescription opioids? If so, your child may be at higher risk of using prescription opioids nonmedically. We also found that conversations about your disapproval of nonmedical prescription opioid use with girls may be effective. However, additional strategies may be necessary for boys since we do not find a significant relationship between parent disapproval and nonmedical prescription opioid use among males.”

The findings emphasize the need for interventions that address peer norms, such as personalized normative feedback interventions, social norms campaigns or peer-led interventions, Dr. Egan said. Future research is needed to better understand parental strategies to dissuade nonmedical prescription opioid use among male adolescents.

In addition to Dr. Egan, the research team included her mentor, Dr. Linda B. Cottler, a professor of epidemiology and associate dean for research at the UF College of Public Health and Health Professions; Dr. Vicki Osborne, a Ph.D. graduate of the UF department of epidemiology who is now a principal research fellow at the UK’s Drug Safety Research Unit; and Dr. Eric Gregory of Community Survey Solutions located in Bowling Green, Kentucky.