Men’s Use and Abuse of Opioids from Early to Middle Adulthood

Introduction: Relatively little is known about the prevalence of use and abuse of opioids across time in adulthood and the associations that symptoms of psychopathology and use of other substances have with opioid use within community samples. Three multivariate models of risk factors for opioid abuse were examined: (a) parental substance use during the men’s adolescence; (b) the men’s own risk behaviors in adolescence—delinquent behavior, depressive symptoms, and use of tobacco, alcohol, marijuana, and opioids; and (c) within- and between-individual effects of the men’s own risk behaviors during adulthood.

Methods: The approach involved a longitudinal study of at-risk community boys (N = 206) followed from late childhood to adulthood, men’s reports of opioid use and abuse were assessed on 13 occasions from ages 20­–21 years to approximately age 37–38 years. Parents’ reported on their own substance use during the boys’ adolescence.

Results: Approximately 40% of men reported prescribed opioid use, and 29% reported opioid abuse at least once. Parental substance use did not predict men’s opioid use patterns. Men’s delinquency in adolescence and alcohol and marijuana use in adulthood were the most robust multivariate predictors of who used and abused opioids; the risk factors generally did not discern prescribed users from non-users. Increases in opioid use with age accounted for all within-subjects effects, except for the increased odds of prescribed opioid use (vs. non-use) in years of greater tobacco use.

Conclusion: Overall, pathways to opioid abuse risk are apparent by adolescence, and suggest that preventing problem behavior and using such histories to inform screening for abuse risk in adulthood may reduce the burden of the opioid crisis.