Association between childhood maltreatment and non-medical prescription opioid use among Chinese senior high school students: The moderating role of gender

•Childhood maltreatment (physical abuse, emotional abuse, sexual abuse, physical neglect, and emotional neglect) are positively associated with an increased risk of lifetime NMPOU.•Gender played a moderator role in the association between emotional/sexual abuse and lifetime NMPOU.•The female students who reported having experienced emotional/sexual abuse had a significantly higher prevalence of lifetime NMPOU than the male students. Non-medical prescription opioid use (NMPOU) and childhood maltreatment are currently serious problems among adolescents worldwide, and childhood maltreatment may be associated with the increased rates of NMPOU. This study examined the specific associations between particular types of childhood maltreatment and lifetime NMPOU and assessed whether gender has a moderating effect on these associations. A 3-stage, stratified cluster, randomized sampling method was used to collect data from 11,194 high school students in Chongqing. The prevalence of the lifetime NMPOU among senior high school students in Chongqing was 7.7%. Physical abuse (AOR = 1.11, 95% CI = 1.07–1.14), emotional abuse (AOR = 1.05, 95% CI = 1.03–1.08), sexual abuse (AOR = 1.04, 95% CI = 1.01–1.07), physical neglect (AOR = 1.06, 95% CI = 1.04–1.09), and emotional neglect (AOR = 1.03, 95% CI = 1.02–1.04) were all positively associated with lifetime NMPOU. The moderating effects of gender on emotional abuse (P = 0.004) and sexual abuse (P = 0.019) were statistically significant in the adjusted model of lifetime NMPOU. According to the stratification analyses in which the male and female students were analyzed separately, female students who previously experienced emotional/sexual abuse had a higher prevalence of lifetime NMPOU. The study sample only contained school students and cross-sectional design limited our ability to make causal inferences. Childhood maltreatment was positively associated with lifetime NMPOU, and gender had a moderating effect on the associations between childhood maltreatment and lifetime NMPOU. Early identification of and intervention for childhood maltreatment victims, particularly female victims, may help reduce the lifetime risk of NMPOU.