Table 2.
Direct Effect of ACEs on Prescription Opioid Misuse: National Epidemiological Survey on Alcohol and Related Conditions, 2012–2013
| Variable | Prescription opioid misuse outcomes | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Past-year opioid misuse | Lifetime opioid misuse | Early onset of opioid misuse | Past-year OUD | Lifetime OUD | Opioid misuse frequency | |||||||
| AOR | (95% CI) | AOR | (95% CI) | AOR | (95% CI) | AOR | (95% CI) | AOR | (95% CI) | β | (95% CI) | |
| ACE score | 1.03 | (1.00, 1.06) | 1.04 | (1.02, 1.06) | 1.07 | (1.03, 1.10) | 1.05 | (0.99, 1.10) | 1.06 | (1.02, 1.10) | 0.01 | (0.002, 0.02) |
| Internalizing symptoms | 1.06 | (1.04, 1.07) | 1.05 | (1.04, 1.06) | 1.04 | (1.02, 1.06) | 1.14 | (1.11, 1.17) | 1.13 | (1.11, 1.15) | 0.02 | (0.02, 0.03) |
| Externalizing symptoms | 1.13 | (1.10, 1.16) | 1.16 | (1.14, 1.18) | 1.20 | (1.17, 1.24) | 1.16 | (1.11, 1.22) | 1.19 | (1.15, 1.23) | 0.07 | (0.06, 0.08) |
| Sex: female | 1.04 | (0.93, 1.16) | 0.91 | (0.85, 0.98) | 0.86 | (0.75, 0.99) | 0.97 | (0.77, 1.23) | 0.98 | (0.82, 1.15) | 0.02 | (−0.01, 0.05) |
| Age | 0.99 | (0.99, 1.00) | 0.99 | (0.99, 1.00) | 0.96 | (0.95, 0.96) | 1.00 | (0.99, 1.01) | 0.99 | (0.99, 1.00) | 0.001 | (0.001, 0.002) |
| Race/ethnicity | ||||||||||||
| Non-Hispanic white | (Ref) | (Ref) | (Ref) | (Ref) | (Ref) | (Ref) | ||||||
| Non-Hispanic black | 1.06 | (0.92, 1.21) | 0.66 | (0.60, 0.73) | 0.52 | (0.43, 0.63) | 0.96 | (0.72, 1.28) | 0.51 | (0.40, 0.64) | 0.04 | (−0.002, 0.07) |
| American Indian | 0.90 | (0.61, 1.31) | 0.69 | (0.53, 0.91) | 0.45 | (0.26, 0.78) | 0.83 | (0.40, 1.75) | 0.72 | (0.43, 1.21) | −0.04 | (−0.16, 0.08) |
| Non-Hispanic Asian | 0.62 | (0.43, 0.90) | 0.60 | (0.48, 0.75) | 0.51 | (0.32, 0.82) | 0.38 | (0.12, 1.21) | 0.39 | (0.19, 0.80) | −0.04 | (−0.11, 0.02) |
| Hispanic | 0.88 | (0.75, 1.03) | 0.67 | (0.60, 0.74) | 0.60 | (0.49, 0.73) | 0.85 | (0.61, 1.20) | 0.51 | (0.39, 0.66) | −0.03 | (−0.07, 0.01) |
| Education | ||||||||||||
| Less than high school | (Ret) | (Ref) | (Ref) | (Ref) | (Ref) | (Ref) | ||||||
| High school | 0.98 | (0.83, 1.15) | 1.03 | (0.92, 1.16) | 1.09 | (0.88, 1.35) | 0.83 | (0.61, 1.12) | 0.88 | (0.69, 1.12) | −0.05 | (−0.10, −0.01) |
| Some college | 0.90 | (0.77, 1.05) | 1.15 | (1.03. 1.29) | 1.11 | (0.90, 1.37) | 0.67 | (0.49, 0.91) | 0.80 | (0.63, 1.01) | −0.08 | (−0.12, −0.04) |
| College | 0.78 | (0.63, 0.95) | 1.09 | (0.95, 1.26) | 0.94 | (0.71, 1.23) | 0.40 | (0.25, 0.66) | 0.59 | (0.43, 0.82) | −0.13 | (−0.18, −0.08) |
| Graduate school | 0.76 | (0.59, 1.00) | 0.96 | (0.81, 1.14) | 0.90 | (0.62, 1.32) | 0.33 | (0.16, 0.68) | 0.45 | (0.28, 0.72) | −0.12 | (−0.18, −0.06) |
| Married: yes | 0.75 | (0.66, 0.84) | 0.81 | (0.75, 0.87) | 0.86 | (0.74, 1.01) | 0.81 | (0.62, 1.05) | 0.92 | (0.77, 1.10) | −0.06 | (−0.09, −0.03) |
| Region | ||||||||||||
| Northeast | (Ref) | (Ref) | (Ref) | (Ref) | (Ref) | (Ref) | ||||||
| Midwest | 1.31 | (1.10, 1.57) | 1.23 | (1.09, 1.39) | 1.52 | (1.20, 1.93) | 0.96 | (0.67, 1.37) | 0.80 | (0.61, 1.04) | 0.07 | (0.02, 0.12) |
| South | 1.14 | (0.97, 1.36) | 1.17 | (1.04, 1.31) | 1.33 | (1.06, 1.67) | 0.85 | (0.61, 1.18) | 0.90 | (0.71, 1.14) | 0.05 | (0.01, 0.09) |
| West | 1.28 | (1.07, 1.53) | 1.27 | (1.13, 1.44) | 1.49 | (1.17, 1.88) | 0.83 | (0.58, 1.19) | 0.87 | (0.68, 1.12) | 0.06 | (0.01, 0.10) |
| Unemployed: yes | 1.06 | (0.89, 1.27) | 1.11 | (0.98, 1.26) | 1.00 | (0.81, 1.23) | 0.95 | (0.66, 1.36) | 1.13 | (0.88, 1.45) | −0.01 | (−0.07, 0.04) |
| Cannabis use: yes | 2.90 | (2.57, 3.28) | 4.35 | (4.01, 4.71) | 4.20 | (3.54, 5.00) | 2.56 | (1.95, 3.37) | 4.08 | (3.30, 5.04) | 0.23 | (0.20, 0.26) |
| Tobacco use: yes | 1.56 | (1.39, 1.76) | 1.48 | (1.36, 1.60) | 1.76 | (1.51, 2.06) | 1.73 | (1.31, 2.27) | 1.81 | (1.48, 2.21) | 0.11 | (0.08, 0.14) |
| n | 36,034 | 36,201 | 36,066 | 36,211 | 36,211 | 36,022 | ||||||
AOR = adjusted odds ratio; CI = confidence interval
All models were adjusted for internalizing and externalizing symptoms, sex, race/ethnicity, education, marital status, region, employment status, cannabis use, and tobacco use.