Neighborhood disadvantage and prescription drug misuse in low-income urban mothers

Prescription drug misuse remains a persistent problem in the United States. Residents living in disadvantaged neighborhoods are at greater risk of substance abuse such as alcohol, tobacco, or drugs. However, whether neighborhood disadvantage affects prescription drug misuse remains underexplored. This study uses data on 3444 mothers from the Fragile Families and Child Wellbeing Study to examine the role of neighborhood disadvantage in prescription drug misuse. In addition, we examine whether social support and neighborhood collective efficacy (social cohesion and social control) explain this relationship. The analysis uses multivariate logistic regression and delineated between the following neighborhoods: affluent (3% poverty), low poverty (3–10%), moderate poverty (10–20%), and high poverty neighborhoods (20% or more). Mothers living in moderately poor neighborhoods were more than twice as likely (odds = 2.17, 95% CI: 1.43–3.27) to misuse prescription drugs than mothers living in neighborhoods with high poverty. Mothers living in neighborhoods with high poverty did not have a statistically significant difference in prescription drug misuse than those living in affluent or low poverty neighborhoods. Social support and neighborhood collective efficacy did not explain these associations. The association between moderate poverty and prescription drug misuse was mostly direct and there was no indirect association. The study highlights the higher risk of prescription drug misuse among mothers living in neighborhoods with moderate poverty. Interventions aimed at reducing opioid misuse should focus on demographic groups that are more vulnerable such as low-income mothers living in disadvantaged neighborhoods. •Study examines neighborhood poverty and prescription drug misuse.•Moderately poor neighborhoods had twice the risk of opioid misuse than highly poor.•Those in highly poor neighborhoods had same risk of opioid misuse than lower poverty.•Social support and collective efficacy did not explain these associations.