An Exploratory Study of Prescription Pain Medication Misuse with and Without Heroin Use among Adolescents

Aims: Opioid misuse is an epidemic in the United States and globally, with adolescents affected by negative consequences including overdoses and deaths. Understanding how mental health and substance use relate to specific types of opioid use is thus important. Methods: Data from the 2019 Connecticut Youth Risk Behavior Survey were analyzed. Chi squares and adjusted odds ratios were computed to relate demographic variables, mental health, and substance use measures to misuse of prescription pain medications with and without heroin use, as compared to neither . Results: Among 1,931 high-school respondents, 8.8 % (n=180) reported prescription pain medication misuse (PPMM+), and 1.4 % (n=28) also reported using heroin (PPMM/HU+). PPMM+ was associated with being female while PPMM/HU+ was associated with being non-White and male. Poorer mental health was associated with PPMM+, and suicidality measures were strongly related to PPMM/HU+. Use of other substances was reported with PPMM+ and PPMM/HU+, with use of vapor products, including on school grounds, particularly linked to the latter. Conclusions: PPMM+ and PPMM/HU+ are associated with suicidality and substance use among adolescents, with suicidality particularly related to PPMM/HU+. Having access to and using substances on school property suggests the need for school -based and other interventions.