Opioid misuse during late adolescence and its effects on risk behaviors, social functioning, health, and emerging adult roles.

Opioid misuse has emerged in recent years as a major public health concern in the United States, particularly for adolescents and emerging young adults. We examined the association of opioid misuse from ages 18 to 20 with four domains at age 21-22: risk behaviors and consequences; health; social functioning; and emerging adult roles. Participants were surveyed annually from 2008 through 2019. The sample includes N = 2880 youth from waves 8-11. The sample was approximately 18 years old at wave 8; 54% female, 46% Hispanic, 20% white, 20% Asian, 2% Black, and 11% multiracial. Opioid misuse was low in this general sample of young adults, with about 4% reporting misuse from age 18-20. We used latent growth curve modeling to examine how misuse from ages 18-20 was associated with functioning at age 21-22. Adolescents who reported opioid misuse at age 18 also reported more negative consequences from alcohol and cannabis use and greater odds of other prescription drug misuse at age 21-22 than those with no misuse. Those reporting opioid misuse at age 18 were also more likely to engage in sexual risk behaviors, report delinquent behavior, and have a higher likelihood of experiencing sexual victimization and engaging in sexual perpetration at age 21-22 than those with no misuse. Neither the intercept nor slope of opioid misuse was associated with depression, anxiety, physical health or ailments, satisfaction with friends, romantic relationship functioning, or emerging adult roles at wave 11. Findings highlight the importance of screening and brief intervention for adolescents reporting opioid misuse.