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Discover Pediatric Collections on COVID-19 and Racism and Its Effects on Pediatric Health

American Academy of Pediatrics
Article

Nonmedical Prescription Opioid Use by Parents and Adolescents in the US

Pamela C. Griesler, Mei-Chen Hu, Melanie M. Wall and Denise B. Kandel
Pediatrics March 2019, 143 (3) e20182354; DOI: https://doi.org/10.1542/peds.2018-2354
Pamela C. Griesler
aDepartments of Psychiatry,
bNew York State Psychiatric Institute, New York, New York; and
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Mei-Chen Hu
aDepartments of Psychiatry,
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Melanie M. Wall
aDepartments of Psychiatry,
bNew York State Psychiatric Institute, New York, New York; and
cBiostatistics, and
dResearch Foundation for Mental Hygiene, New York, New York
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Denise B. Kandel
aDepartments of Psychiatry,
bNew York State Psychiatric Institute, New York, New York; and
eSociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York;
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    TABLE 1

    Characteristics of Parents and Adolescents in Parent-Adolescent Dyads (2004–2012 NSDUH)

    CharacteristicParents (N = 35 000)Adolescents (N = 35 000)
    Age, y43.4 (7.0)14.5 (1.7)
    Female sex, %56.747.5
    Parent-child dyads, %
     Mother and son29.6—
     Mother and daughter27.1—
     Father and son22.9—
     Father and daughter20.4—
    Race and/or ethnicity, %
     African American—12.2
     White—60.4
     Hispanic—19.7
     Other—7.7
    Education, %
     High school or less44.4—
     Some college26.4—
     College graduate29.2—
    Marital status, %
     Married79.2—
     Separated or divorced12.9—
     Widowed1.2—
     Never married6.7—
    Perceived parenting by adolescent (past 12 mo), mean (SD)
     Lack of monitoring2.1 (0.7)—
     Conflict1.6 (0.8)—
     Lack of support2.9 (1.4)—
    Lifetime, %
     NMPOsa13.58.8
     Smoking68.920.6
     Alcohol88.735.6
     Marijuana51.015.2
     OIDsb24.63.8
    Initiated other drug before NMPOs, %
     Cigarettes—18.8
     Alcohol—32.9
     Marijuana—13.1
     OIDsc—2.1
    Perceived risk of drug use (range 0–6), mean (SD)4.8 (1.3)4.1 (1.7)
    Perceived drug use of schoolmates,b %
     None or a few use—52.7
     Most or all use—47.3
    Religiosity (range 1–4), mean (SD)—2.5 (0.8)
    Delinquency (past 12 mo; range 0–6), mean (SD)—0.5 (0.9)
    Lifetime depression, %12.812.2
    • Weighted estimates. —, not applicable.

    • ↵a Includes 21 prescription opioids: Darvocet, Darvon, and Tylenol with Codeine (as a group); Percocet, Percodan, and Tylox (as a group); Vicodin, Lortab, and Lorcet (as a group); Codeine; Demerol; Dilaudid and Fioricet; Fiorinal; Hydrocodone; Methadone; Morphine; Oxycontin; Phenaphen with Codeine; Propoxyphene; Sk-65; Stadol; Talacen; Talwin; Talwin Nx; Tramadol; and Ultram.

    • ↵b Cocaine, crack, heroin, or hallucinogens.

    • ↵c Smoking, alcohol, or marijuana.

    • View popup
    TABLE 2

    Prevalence of Lifetime NMPO Use Among Parents and Adolescents by Sex, Race and/or Ethnicity, and Adolescent Age in Parent-Adolescent Dyads (2004–2012 NSDUH)

    Lifetime NMPO Use, % (95% CI)nP
    Parents
     Mothers12.8 (12.1–13.6)a21 200.05
     Fathers14.3 (13.4–15.3)b13 800__
      Race and/or ethnicity
      White15.6 (14.8–16.4)a23 500.001
      African American9.6 (8.2–11.2)b4000—
      Hispanic9.2 (8.0–10.4)b5400—
      Other11.7 (9.2–14.7)b2200—
    Adolescents
     Male8.5 (7.8–9.3)17 900ns
     Female9.2 (8.5–9.9)17 100—
     Race and/or ethnicity
      White9.2 (8.6–9.9)22 100ns
      African American8.3 (6.9–9.8)3900—
      Hispanic8.8 (7.8–9.9)6200—
      Other7.0 (5.4–8.9)2800—
     Age, y
      124.4 (3.5–5.6)a6300.001
      134.6 (3.8–5.7)a6500—
      146.2 (5.3–7.4)b6000—
      1511.0 (9.7–12.5)c5700—
      1612.1 (10.9–13.4)c5500—
      1714.5 (13.1–16.0)d5000—
    • Weighted estimates. For each characteristic (sex, race and/or ethnicity, and age), different superscripts indicate significant group differences at P < .05. ns, not significant; —, not applicable.

    • View popup
    TABLE 3

    Logistic Regression of Parent and Adolescent Characteristics on Adolescent Lifetime Use of NMPOs (2004–2012 NSDUH)

    Characteristics OR (95% CI), (n = 35 000) aOR (95% CI), (n = 35 000)
    Parents
     Age1.00 (0.99–1.01)1.00 (0.99–1.01)
     Mothers (versus fathers)1.05 (0.93–1.19)1.02 (0.89–1.17)
     Education (versus college graduate)
      Some college1.39 (1.16–1.68)***1.09 (0.89–1.34)
      High school graduate or less1.64 (1.37–1.95)***1.19 (0.97–1.46)
     Marital status (versus married)
      Widowed1.43 (0.89–2.29)1.42 (0.82–2.46)
      Separated or divorced1.50 (1.26–1.78)***1.08 (0.90–1.31)
      Never married1.16 (0.94–1.42)0.94 (0.72–1.22)
     Lifetime substance use (versus never)
      NMPOs1.84 (1.58–2.15)***1.30 (1.09–1.56)**
      Smoking1.76 (1.51–2.05)***1.24 (1.02–1.51)*
      Alcohol1.63 (1.31–2.03)***1.23 (0.93–1.63)
      Marijuana1.65 (1.45–1.89)***1.13 (0.93–1.36)
      OIDsa1.76 (1.54–2.01)***1.18 (0.98–1.41)
     Perceived risk of drug useb0.86 (0.82–0.91)***0.93 (0.87–1.00)*
     Lifetime depression (versus never)1.38 (1.16–1.65)***1.04 (0.85–1.26)
     Perceived parenting by child (past 12 mo)b
      Lack of monitoring1.59 (1.50–1.68)***1.21 (1.12–1.31)***
      Lack of support1.43 (1.35–1.51)***1.05 (0.98–1.12)
      Conflict1.54 (1.44–1.65)***1.19 (1.10–1.29)***
    Adolescents
     Age1.34 (1.28–1.39)***1.27 (1.21–1.34)***
     Boys (versus girls)0.92 (0.80–1.05)0.89 (0.76–1.03)
     Race and/or ethnicity (versus African American)
      White1.13 (0.92–1.39)1.06 (0.83–1.36)
      Hispanic1.07 (0.84–1.36)1.08 (0.81–1.43)
      Other0.83 (0.60–1.16)0.97 (0.67–1.40)
     Religiosityb0.71 (0.67–0.76)***0.92 (0.86–0.99)*
     Initiated other drug before NMPO (versus same age, after, or did not use)
      Cigarettes3.01 (2.64–3.43)***1.37 (1.14–1.65)***
      Alcohol1.65 (1.46–1.87)***0.47 (0.39–0.55)***
      Marijuana3.03 (2.63–3.50)***1.25 (1.02–1.53)*
      OIDsa3.66 (2.72–4.93)***0.98 (0.63–1.51)
     Perceived risk of drug useb0.71 (0.68–0.75)***0.77 (0.72–0.82)***
     Perceived drug use of schoolmates (versus none or some use)c
      Most or all use3.54 (3.04–4.11)***1.71 (1.44–2.04)***
     Delinquency (past 12 mo)b1.72 (1.63–1.80)***1.50 (1.42–1.59)***
     Lifetime depression (versus never)2.83 (2.43–3.29)***1.62 (1.37–1.93)***
    • Weighted estimates.

    • ↵a Cocaine, crack, heroin, or hallucinogens.

    • ↵b Standardized scores.

    • ↵c Smoking, alcohol, or marijuana.

    • ↵* P < .05; ** P < .01; *** P < .001.

    • View popup
    TABLE 4

    Effects of Parental Lifetime NMPO Use by Parent and Adolescent Sex on Adolescent Lifetime NMPO Use (2004–2012 NSDUH)

    Parent-Adolescent DyadsAdolescent NMPO Use, aOR (95% CI)an
    All parents
     Mothers1.62 (1.28–2.05)**,b21 200
     Fathers0.98 (0.74–1.24)c13 800
    Dyads by sex
     Mother-daughter pairs1.70 (1.25–2.30)***,b10 500
     Mother-son pairs1.53 (1.08–2.15)*,b10 700
     Father-daughter pairs1.25 (0.86–1.80)b6600
     Father-son pairs0.71 (0.50–1.00)*,c7200
    • Models were controlled for parent and adolescent factors included in Table 3.

    • ↵a In separate models, the interaction effects of parental NMPO use by parent sex and of parental NMPO use by parent and adolescent sex are each statistically significant (P < .01 and P < .001, respectively).

    • ↵b Different superscripts indicate a statically significant difference at P < .05.

    • ↵c Different superscripts indicate a statically significant difference at P < .05.

    • ↵* P < .05; ** P < .01; *** P < .001.

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Nonmedical Prescription Opioid Use by Parents and Adolescents in the US
Pamela C. Griesler, Mei-Chen Hu, Melanie M. Wall, Denise B. Kandel
Pediatrics Mar 2019, 143 (3) e20182354; DOI: 10.1542/peds.2018-2354

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Nonmedical Prescription Opioid Use by Parents and Adolescents in the US
Pamela C. Griesler, Mei-Chen Hu, Melanie M. Wall, Denise B. Kandel
Pediatrics Mar 2019, 143 (3) e20182354; DOI: 10.1542/peds.2018-2354
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