(see Poster Gallery) Risk and Protective Factors of Opioid Use Among Young Adults Who Were Serious Violent Juvenile Offenders

BACKGROUND AND PURPOSE: Even though opioid-related overdoses have continued to surge during the pandemic, studies have yet to explore key risk and protective factors for opioid use among high-risk young adults (20-25 years old), who have spent time in a juvenile justice facility. Applying a strain theory framework (Agnew, 2006), we control for characteristics that have been associated with an increased risk of opioid misuse, including being White (Schuler, Schell, & Wong, 2021; Snyder & Merritt, 2016), being older (Wall & Kohl, 2007), having a history of juvenile offending (Adams et al., 2013), having a history of psychiatric hospitalization (Yule et al. 2108), being morally disengaged (Wojciechowski, 2021), and being exposed to violence during adolescence (Dubow et al., 2008). Protective factors include having a mother who is warm (Cerdá et al., 2014) and having a future orientation (Johnson & Cottler, 2020).

Opioids are a class of drugs, including heroin and prescription pain relievers (e.g., oxycodone, hydrocodone, codeine, morphine, and fentanyl), that activate opioid receptor proteins in the body and the brain to diminish pain signals’ intensity. Opioids can be natural (i.e., alkaloids derived from the resin of plants, such as the opium poppy), semi-synthetic (i.e., created in a laboratory from natural opiates), or synthetic (i.e., generated in a laboratory from artificial compounds; Koob et al., 2014). Different opioids contain different molecules, which produce varying levels of euphoria and withdrawal symptoms (Compton et al., 2016).

METHODS: Data are from the Pathways to Desistance prospective study of serious juvenile offenders, which includes participants from Phoenix, Arizona (n = 565) and Philadelphia, Pennsylvania (n = 605) (Mulvey, 2016). These data are made available to participating universities by the Inter-university Consortium for Political and Social Research (ICPSR). Study enrollment began in November 2000 and concluded in January 2003. Each participant was followed for seven years until April 2010. Follow-up interviews took place at 6, 12, 18, 24, 30, 36, 48, 60, 72 and 84 months beyond the baseline assessment (http://www.pathwaysstudy.pitt.edu/). The dependent variable was opiate use during the past month measured at 84 months after baseline (emerging adulthood). Measures from the baseline interview included site location, sex, white race, and psychiatric hospitalization. Measures taken at 24 months included exposure to violence and victimization, moral disengagement, and future orientation. Stata 14.1 was used for analyses. Logistic regression was used to model the dichotomous outcome variable, opiate use during emerging adulthood.

RESULTS: Being White (OR = 3.08, p< 0.05), experiencing moral disengagement (OR = 2.82, p< 0.01), being exposed to violence (OR = 2.17, p<0.05), and being hospitalized for psychiatric treatment (OR=2.45, p<0.05) increased the likelihood of opiate use, while future orientation reduced the risk of opioid use (OR = -2.01, p<0.05).

IMPLICATIONS FOR PRACTICE: Study results highlight risk and protective factors associated with opiate use among emerging adults who were serious juvenile offenders. Prevention and intervention strategies need to target youth who are morally disengaged, those who have had psychiatric hospitalizations, and youth with exposure to violence. Likewise, interventions should help youth develop future orientations.