Factors influencing the non-medical use of prescription opioids among youth: results from the COMPASS study (2020)

Objective: To investigate demographic and behavioral risk factors for non-medical use of prescription opioids.
Methods: Canadian high school students taking part in the COMPASS study reported non-medical use of prescription opioids in three categories (oxycodone, fentanyl, other prescription pain relievers) in 2017/2018. Factors of interest were collected at two baselines (2016/2017; 2015/2016) and included validated demographic (age, gender, race/ethnicity, spending money), substance use (alcohol, tobacco, cannabis), and school-related (connectedness, homework completion, truancy) measures.
Results: In total, 18,826 and 7,967 students were linked between 2017/2018 and 2016/2017 or 2015/2016 respectively. Use of fentanyl was least prevalent (0.7% and 1.0% respectively), with the use of oxycodone (1.7% and 1.9%) more and use of other prescription pain relievers (4.9% and 5.1%) most common. Male gender, substance use, and lack of homework completion were associated with the use of oxycodone and other prescription pain relievers. School connectedness was identified as a potential protective factor.
Conclusions: Two-thirds of significant associations found were present only in one of the two models, highlighting the complexity of non-medical use of prescription opioids among youth. School connectedness may lower the risk of non-medical use of prescription opioids, indicating that a school-based focus is justified.