While much has been published about the use of tobacco, alcohol, and marijuana use in high schools in this country, little has been published regarding the medical use and misuse of prescription opioids in adolescents, and how the school environment might promote or discourage such misuse. McCabe et al (10.1542/peds.2020-0387) offer us insight into the school-level prevalence of opioid use and factors associated with medical use and misuse of prescription opioids by studying over 228,000 high school seniors in the US across >1000 public and private schools from 2002 to 2017. The authors analyzed data reported by adolescents in the Monitoring the Futures study, a multi-cohort national survey of high school students with a response rate of over 80% on average for 12th grade students. The authors set out to examine the overall prevalence of medical use of prescription opioids as well as look at prescription opioid misuse (POM) based on whether a high school was public or private and urban or rural. Their findings are rich and of great relevance to all. The authors discovered major variations in medical use and POM. For example, the overall prevalence of prescription misuse was 7.6% but the range at individual schools was 0 to 73%. Medical use prevalence was 16.9% in those surveyed but again medical use varied by school from 0% to 85%.
The higher the medical use of prescription opioids, the stronger the association with POM, although the strength of this association has been less strong in recent years. There are many other variables identified that appear to influence POM both at a school and individual levels. For example, the odds of POM were higher outside of the northeastern region, in suburban and rural vs. urban areas, in schools with more male students, among White students, and those with higher rates of marijuana use.
This study provides data that might help you consider your local risk. Of course, there is always the chance that the students’ may underreport opioid misuse. This study also excluded those who are home-schooled. Still, there is much to be learned from reading this study that could be adaptable to your local high schools in the area—so do the homework and link to this study to learn more.