Power of the Peer and Parent: Gender Differences, Norms, and Nonmedical Prescription Opioid Use Among Adolescents in South Central Kentucky

  • Kathleen L. EganEmail author
  • Eric Gregory
  • Vicki L. Osborne
  • Linda B. Cottler


This study examined risk factors of nonmedical prescription opioid use (NMPOU) among adolescents and how risk factors differ by gender. In the fall of 2017, adolescents attending 6th through 12th grades across 44 schools in 10 south central Kentucky counties were invited to participate in an anonymous, school-based survey. A total of 11,761 adolescents completed the survey. Logistic regression was conducted to examine the association between NMPOU and constructs of the Theory of Reasoned Action (i.e., attitudes and subjective norms), descriptive norms (i.e., peer use), and parental control of prescription medications in the home. There were 297 (2.7%) adolescents who reported NMPOU in the past 12 months. In the adjusted multivariate logistic regression model, for both males and females, the adolescents who perceived that more of their peers engaged in NMPOU were significantly more likely to endorse NMPOU, whereas male and female adolescents who perceived their peers disapproved of use were significantly less likely to report NMPOU. Parent disapproval was significantly associated with decreased NMPOU for females only. Moderated regression analyses revealed that gender moderated the relationship between parental disapproval and NMPOU. We found that during adolescence, NMPOU is influenced by peer norms for both genders and parental norms for females. These results indicate that prevention efforts should focus on changing adolescents’ peer and parental norms related to NMPOU.


Prescription drug Opioid Adolescent Norm Availability 



Research reported in this article was supported by the NIDA T32 training grant at the UF Substance Abuse Training Center in Public Health from the National Institutes of Health (T32DA035167) and Substance Abuse and Mental Health Services Administration under SP019436. The content is solely the responsibility of the authors and does not represent the official views of the National Institute of Health or Substance Abuse and Mental Health Services Administration.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Research Involving Human Participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

For this type of study, formal consent was not required.


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Copyright information

© Society for Prevention Research 2019

Authors and Affiliations

  1. 1.Department of Heath Education and PromotionEast Carolina UniversityGreenvilleUSA
  2. 2.Community Survey SolutionsLLCBowling GreenUSA
  3. 3.Drug Safety Research UnitSouthamptonUK
  4. 4.Department of EpidemiologyUniversity of FloridaGainesvilleUSA

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