School Environmental Factors and Prescription Opioid Misuse in the United States: Evidence from the 2019 National Survey

Background: Given the current public health crisis caused by opioid abuse across the United States, this study analyzed factors in the school environment associated with the misuse of prescription opioids among adolescents in the United States. Methods: This study used secondary data collected by the Centers for Disease Control and Prevention for the 2019 National Youth Risk Behavior Surveillance survey (N=13,677). Descriptive analysis and multivariable logistic analysis were performed to examine the association between opioid misuse among young people and factors in their school environment. Results: The study results showed that the odds of current opioid misuse in adolescents were three times higher in the students who had carried weapons at least once at school (Adjusted Odds Ratios, AOR, 3.27; CI, 1.97-5.42) compared to students who did not carry weapons, at P<0.001. Other significant risk factors included physical fighting at school, safety concerns at school, and perception of being threatened at school at P<0.001. Conclusion: The school can be a critically important stakeholder in the implementation of policies and programs to tackle the current opioid epidemic in America.