Background: Given the current public health crisis caused by prescription opioid misuse among
adolescents across the United States, this study analyzed factors in the school environment
associated with prescription opioid misuse in adolescents in the United States.
Methods: Using a cross-sectional quantitative study design, multivariable analysis was
performed on data from the 2019 National Youth Risk Behavior Surveillance survey
Results: The study results showed that the odds of current and lifetime opioid misuse in
adolescents were 3 times higher for the students who carried weapons at least one day at school
(Adjusted odds ratios, AOR, 3.03; CI, 2.13-4.33) compared to students who did not carry
weapons. Other significant risk factors included physical fighting at school, safety concerns at
school, and perception of being threatened at school.
Conclusion: The school can be a critically important stakeholder in the implementation of
policies and programs to tackle the current opioid epidemic in America.