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Association of childhood abuse and neglect with prescription opioid misuse: Examination of mediation by adolescent depressive symptoms and pain

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  • Austin, Anna E.
  • Shanahan, Meghan E.

Abstract

Previous research has demonstrated an association between childhood abuse and neglect and prescription opioid misuse in adulthood. However, potential mechanisms underlying this association remain unclear. Based on the self-medication hypothesis and the existing research literature, we hypothesized that pain and depressive symptoms would mediate this association. Data were from Waves I (1994–1995) and III (2002) of the National Longitudinal Study of Adolescent to Adult Health (Add Health; N = 14,322). We conducted structural equation modeling to examine the association of childhood abuse and neglect with prescription opioid misuse in early adulthood and to assess for mediation by depressive symptoms and pain in adolescence. One in five respondents (20.1%) reported prescription opioid misuse in early adulthood. Childhood abuse and neglect was directly associated with an increase in the predicted probability of prescription opioid misuse (β = 0.232, p < 0.001). Pain, but not depressive symptoms, in adolescence was a significant mediator of this association (β = 0.019, p < 0.001). Pain may represent a complex stress-related response to early trauma among adolescents and may contribute to subsequent prescription opioid misuse as a coping mechanism. Results highlight the need to promote positive coping skills among adolescents who have experienced childhood abuse and neglect and underscore the importance of trauma-informed treatment services for individuals misusing prescription opioids.

Suggested Citation

  • Austin, Anna E. & Shanahan, Meghan E., 2018. "Association of childhood abuse and neglect with prescription opioid misuse: Examination of mediation by adolescent depressive symptoms and pain," Children and Youth Services Review, Elsevier, vol. 86(C), pages 84-93.
    • Handle: RePEc:eee:cysrev:v:86:y:2018:i:c:p:84-93
    DOI: 10.1016/j.childyouth.2018.01.023
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    1. Jutta Lindert & Ondine Ehrenstein & Rachel Grashow & Gilad Gal & Elmar Braehler & Marc Weisskopf, 2014. "Sexual and physical abuse in childhood is associated with depression and anxiety over the life course: systematic review and meta-analysis," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 59(2), pages 359-372, April.
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    1. Jessica Roberts Williams & Veronica Cole & Susan Girdler & Martha Grace Cromeens, 2020. "Exploring stress, cognitive, and affective mechanisms of the relationship between interpersonal trauma and opioid misuse," PLOS ONE, Public Library of Science, vol. 15(5), pages 1-19, May.

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