Opioid use remains a major public health concern, especially among adolescents and young adults (AYAs). Despite ongoing efforts to mitigate opioid misuse through harm reduction measures and supply-side interventions—such as restricting overprescribing practices and promoting safe medication disposal—the demand-side factors, including the underlying motivations for opioid use and the pathways leading to misuse, remain underexplored. This study seeks to bridge this gap by investigating the pathways to opioid misuse among AYAs in recovery, aiming to enhance prevention strategies by analyzing their personal experiences and the risk factors contributing to opioid use.
The study involved 30 young adults (aged 18–29) and employed a mixed-methods approach, combining brief quantitative surveys with semi-structured, in-depth interviews. The surveys assessed retrospectively reported risk factors, such as emotional neglect, physical and sexual abuse, as well as protective factors like personal resilience and supportive relationships. The interviews explored participants’ personal stories of substance use, recovery, and their suggestions for prevention.
According to the study, the most commonly endorsed risk factors were emotional neglect and abuse, followed by physical and sexual abuse. Participants also disclosed that early struggles with mental health, social disconnection, and difficulties in emotional regulation were significant contributors to opioid initiation. Many individuals reported using opioids as a means of coping with trauma, negative emotions, and feelings of social isolation. However, the study also highlighted positive aspects of participants’ lives, such as personal talents and supportive relationships, which served as protective factors even in the context of substance use difficulties. The findings underscore the necessity for more comprehensive prevention strategies that address emotional well-being and social connectivity, alongside existing harm reduction efforts.
Takeaway: Comprehensive prevention strategies that focus on emotional well-being, social connection, and trauma-informed care are essential to addressing opioid misuse among adolescents and young adults, alongside existing harm reduction efforts.