Nonmedical Prescription Opioid Use by Parents and Adolescents in the US

To date, intergenerational patterns of nonmedical prescription opioid (NMPO) use have not been examined. We investigate the association between parental and adolescent NMPO use in the United States. Data are from 35 000 parent-child dyads with an adolescent aged 12 to 17 years from the 2004-2012 nationally representative National Surveys on Drug Use and Health. Using multivariable logistic regression models, we estimated the association between self-reported parental and adolescent lifetime NMPO use, controlling for parental and adolescent use of other drugs, attitudes about drug use, parental and adolescent psychosocial risk factors, and sociodemographic characteristics. Controlling for other factors, parental NMPO use was associated with adolescent NMPO use (adjusted odds ratio [aOR] 1.30; 95% confidence interval [CI] 1.09-1.56). Mothers' use had a stronger association with adolescent use than fathers' use (aOR 1.62 [95% CI 1.28-2.056] versus aOR 0.98 [95% CI 0.74-1.24]). Associations between parental and adolescent NMPO use did not differ by adolescent sex or race and/or ethnicity. Parental lifetime smoking, low monitoring, and parent-adolescent conflict were uniquely associated with adolescent NMPO use (aOR 1.19-1.24) as were adolescent smoking, marijuana use, depression, delinquency, and perceived schoolmates' drug use (aOR 1.25-1.71). Perceived risk of drug use and religiosity were associated with lower rates of adolescent NMPO use (aOR 0.77-0.93). Use among older adolescents was higher than among younger adolescents (aOR 1.27; 95% CI 1.21-1.34). Parent-based interventions targeted at adolescent NMPO use should address parental NMPO use and smoking and promote positive parenting.