Examining the Role of Social Bonds on Prescription Misuse Among Adolescents in the United States

Introduction: Prescription misuse (PM) among adolescents in the United States is a significant public health issue, with a reported prevalence of 4.9% in 2022. Understanding the role of social bonds such as parental attachment, peer influence and school engagement is crucial for developing effective prevention strategies.

Methods: Data from the 2019 National Survey on Drug Use and Health comprised 11,997 adolescents aged 12-17 years. PM was measured as a binary variable, and social bonds were assessed through scales measuring school bonds, parental bonds and community engagement. Binary logistic regression was employed to examine the impact of social bonds on PM while controlling demographics and peer influence.

Results: Findings indicated that adolescents with higher levels of social bonds, specifically school bonds (adjusted odds ratio [AOR] 0.66, 95% confidence interval [CI] [0.53, 0.83], p < 0.05), parental bonds (AOR 0.59, 95% CI [0.45, 0.77], p < 0.001) and positive peer influence (AOR 0.55, 95% CI [0.43, 0.70], p < 0.0001) are less likely to engage in PM. Females (AOR 1.86, 95% CI [1.39, 2.48], p = 0.0001) and low-income adolescents (AOR 2.05, 95% CI [1.36, 3.08], p = 0.0009) were more likely to engage in PM compared to male and high-income counterparts. No significant associations were found between community engagement and PM in adjusted analyses.

Discussion And Conclusions: This study highlights the protective role of strong parental and social bonds in reducing the risk of PM among US adolescents. The findings highlight the need for income and gender-specific interventions.