Risk and Protective Factors
Individual
While anyone who uses a prescription opioid can become addicted, several risk factors are associated with higher rates of misuse, abuse and addiction. These risk factors include:
- Past and current substance use
- Mental illness
- Male gender
- Younger age
It is important to consider these risk factors when planning prevention activities. Some risk factors, such as previous substance use, may warrant a closer look when prescribing opioids, as alternative treatments may be more suitable to prevent addiction. For other risk factors, such as age, there may be evidence-based school- or college-based prevention activities to consider.
Sources:
Cragg, A., Hau, J. P., Woo, S. A., Kitchen, S. A., Liu, C., Doyle-Waters, M. M., & Hohl, C. M. (2019). Risk factors for misuse of prescribed opioids: A systematic review and meta-analysis. Annals of Emergency Medicine, 74(5).
Katz, C., El-Gabalawy, R., Keyes, K. M., Martins, S. S., & Sareen, J. (2013). Risk factors for incident nonmedical prescription opioid use and abuse and dependence: Results from a longitudinal nationally representative sample. Drug and Alcohol Deppendence, 132(1-2).
McCabe, S. E., Veliz, P. T., Dickinson, K., Schepis, T. S., & Schulenberg, J. E. (2019). Trajectories of prescription drug misuse during the transition from late adolescence into adulthood in the USA: A nationally longitudinal multicohort study. The Lancet, 6(10).
Webster, L. R. (2017). Risk factors for opioid-use disorder and overdose. Anesthesia and Analgesia, 125(5).
Environmental
Access to opioids is a primary environmental risk factor associated with opioid misuse and addiction. Environmental strategies that limit access to opioids, while keeping them available for appropriate medical uses, are necessary to address this risk factor. Examples include prescription drug monitoring programs, pharmacy lock-in programs, and drug disposal programs.
Other Risk/Protective Factors
While the above characteristics are linked with increased risk of opioid misuse, there are many factors that are linked with an increased risk of substance abuse in general. Other factors are protective in nature and are linked with a decreased risk of substance abuse. In Wyoming, the Prevention Needs Assessment (PNA) measures some of these risk and protective factors in local communities.
The tables below list some of the general risk and protective factors associated with substance abuse.
| Risk Factors | Protective Factors |
|---|---|
| Individual | Individual |
| Early initiation of substance use | Social, emotional, behavioral, cognitive, and moral competence |
| Early and persistent problem behavior | Self-efficacy |
| Rebelliousness | Spirituality |
| Favorable attitudes toward substance use | Resiliency |
| Peer substance use | |
| Genetic predictors | |
| Family | Family, School, and Community |
| Family management problems | Opportunities for positive social involvement |
| Family conflict | Recognition for positive behavior |
| Favorable parental attitudes toward substance use | Bonding |
| Family history of substance misuse | Marriage or committed relationship |
| School | Healthy beliefs and standards for behavior |
| Poor grades in school | |
| Lack of commitment to school | |
| Community | |
| Low cost of alcohol | |
| High availability of substances | |
| Community laws and norms favorable to substance use | |
| Media portrayal of alcohol use | |
| Low neighborhood attachment | |
| Community disorganization | |
| Low socioeconomic status | |
| Transitions and mobility |
Source:
Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health