Table 3.
Mediation Effect of Lifetime Externalizing and Internalizing Symptoms on the Association between ACEs and Prescription Opioid Misuse: National Epidemiological Survey on Alcohol and Related Conditions, 2012–2013
| Outcome Variable | Total Effect | Natural Indirect Effect | Proportion Mediated | ||
|---|---|---|---|---|---|
| AOR or β | (95% CI) | AOR or β | (95% CI) | ||
| Mediator: internalizing symptoms | |||||
| Past-year opioid misuse | 1.06 | (1.03, 1.09) | 1.03 | (1.02, 1.03) | 47% |
| Lifetime opioid misuse | 1.07 | (1.05, 1.09) | 1.02 | (1.02, 1.03) | 34% |
| Early onset of opioid misuse | 1.09 | (1.05, 1.12) | 1.02 | (1.01, 1.03) | 22% |
| Past-year OUD | 1.11 | (1.06, 1.17) | 1.06 | (1.05, 1.08) | 58% |
| Lifetime OUD | 1.12 | (1.08, 1.17) | 1.06 | (1.05, 1.07) | 50% |
| Frequency of opioid misusea | 0.02 | (0.01, 0.03) | 0.01 | (0.008, 0.012) | 49% |
| Mediator: externalizing symptoms | |||||
| Past-year opioid misuse | 1.06 | (1.04, 1.09) | 1.03 | (1.02, 1.04) | 50% |
| Lifetime opioid misuse | 1.08 | (1.06, 1.10) | 1.04 | (1.03, 1.04) | 48% |
| Early onset of opioid misuse | 1.12 | (1.08, 1.15) | 1.05 | (1.04, 1.05) | 43% |
| Past-year OUD | 1.09 | (1.03, 1.14) | 1.04 | (1.03, 1.05) | 46% |
| Lifetime OUD | 1.11 | (1.07, 1.15) | 1.04 | (1.04, 1.05) | 43% |
| Frequency of opioid misusea | 0.03 | (0.02, 0.04) | 0.02 | (0.01, 0.02) | 61% |
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.
a
β coefficient was reported.