Bonar Erin E, Kotov Meredith, Bourque Carrie, Carter Patrick M, Clark Sarah J, Hutton David W, Kidwell Kelley M, King Cheryl A, Losman Eve D, McCabe Sean Esteban, Zheng Kai, Walton Maureen
Addiction Center, Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA; Michigan Innovations in Addiction Care through Research & Education Program, Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA; Injury Prevention Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 10, Ann Arbor, MI 48109, USA.
Addiction Center, Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA.
Drug Alcohol Depend. 2025 Jul 30;275:112814. doi: 10.1016/j.drugalcdep.2025.112814.
Opioid misuse/opioid use disorder prevention strategies tailored for risk and protective factors are needed among adolescents and young adults (AYAs). We describe baseline risk/protective factors related to opioid misuse among at-risk AYAs who attended Emergency Departments (EDs) enrolled in a randomized controlled trial.
People who recently visited an ED (ages 16-30) and self-reported 1) past-year prescription opioid use+a risk factor for misuse (i.e., drug use, binge drinking, depression symptoms, suicide risk) or 2) heroin or prescription opioid misuse at screening were enrolled. Measures assessed background characteristics and risk/protective factors. Analyses compared participants based on whether they reported opioid misuse or were at-risk for misuse.
We enrolled 1155 people (27.5 % male); 79.5 % reported opioid use+risk factor and 20.5 % reported opioid misuse. In unadjusted analyses, relative to those with opioid use+risk factor, those with opioid misuse were significantly more likely to report: male sex, Black/African American race, receiving public assistance, food insecurity, stronger opioid use motives, greater substance use, a prior suicide attempt, violence involvement, and greater impulsivity. They also reported lower social support, prosocial activities, and self-efficacy to avoid substances. In adjusted analyses, those with opioid misuse were significantly more likely to be male, have greater alcohol and other substance use, and report violence, with lower self-efficacy and social support.
Social determinants of health, other substance use, social support, self-efficacy, etc., were key factors differentiating AYAs who have misused opioids from those at-risk for future misuse. Prevention and early interventions may be improved via tailoring for these risk/protective factors.
青少年和青年（AYAs）需要针对风险和保护因素量身定制的阿片类药物滥用/阿片类药物使用障碍预防策略。我们描述了参与一项随机对照试验的急诊科（EDs）中，有风险的AYAs中与阿片类药物滥用相关的基线风险/保护因素。
近期去过急诊科（年龄16 - 30岁）且自我报告1）过去一年使用过处方阿片类药物+滥用风险因素（即药物使用、暴饮、抑郁症状、自杀风险）或2）筛查时存在海洛因或处方阿片类药物滥用的人被纳入研究。测量指标评估了背景特征以及风险/保护因素。分析根据参与者是否报告阿片类药物滥用或有滥用风险进行比较。
我们纳入了1155人（27.5%为男性）；79.5%报告使用阿片类药物+风险因素，20.5%报告阿片类药物滥用。在未调整分析中，相对于有阿片类药物使用+风险因素的人，有阿片类药物滥用的人更有可能报告：男性、黑人/非裔美国人种族、接受公共援助、粮食不安全、更强的阿片类药物使用动机、更多的物质使用、既往自杀未遂、暴力参与以及更强的冲动性。他们还报告了更低的社会支持、亲社会活动以及避免使用物质的自我效能感。在调整分析中，有阿片类药物滥用的人更有可能是男性，有更多的酒精和其他物质使用，并报告有暴力行为，同时自我效能感和社会支持更低。
健康的社会决定因素、其他物质使用、社会支持、自我效能感等，是区分滥用阿片类药物的AYAs与未来有滥用风险的AYAs的关键因素。通过针对这些风险/保护因素进行调整，预防和早期干预可能会得到改善。
