Diseases of Despair and Social Capital: Findings from a Population-Based Survey on Opioid Misuse among Adolescents

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Abstract
Background: Deaths related to opioid overdose have increased substantially in the past few years, raising concerns about how to combat this public health emergency. Objectives: We investigated the association of family, school, and community social capital with opioid misuse in the adolescent population. In addition, we examined if adolescents’ depressive symptoms have any mediating effects on opioid misuse. Methods: We used the 2018 National Survey on Drug Use and Health (NSDUH) data, and two substantive models with binary logistic regressions. Three social capital variables were added to the full model with control for sociodemographic and health status variables. A mediation analysis was estimated for family and school social capital, major depressive episodes in the past year, and opioid misuse. Results: We found statistically significant relationships between adolescent opioid misuse and family and school social capital. Adolescents’ odds of opioid misuse decreased 10% with each additional family situation where they felt supported. Not knowing students in their grade who drank alcohol or used marijuana/hashish decreased the odds of misusing opioids 42% (p < .01). Experience of depressive episodes acted as a mediator for the social capital effects on adolescents’ opioid misuse. Conclusions: Our findings lend support that opioid misuse is associated with despair, and therefore, opioid prevention programs need to incorporate strategies to address mental health issues as well. Our findings also underscore the need for focusing on increasing parental awareness and involvement as well as scaling up prevention efforts in high schools where substance abuse is relatively higher.

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