Risk Factors for Opioid Misuse and the Negative Impact of Others' Opioid Misuse

Scale: Risk Factors for Opioid Misuse and the Negative Impact of Others' Opioid Misuse

What it measures:

  • Items address a range of potential risk factors for opioid use among youth and negative impact on youth of others' opioid misuse.

Intended age range: Youth aged 12 and older.

Brief description: Survey items include doctor prescribed opioid use (1 item) and, if yes, age of first opioid prescription (1 item), perceived availability of opioids (2 items), friends’ substance use, including opioids (1 item), perceived risk of harm from the use of opioids (2 items), awareness of opioid misuse by others (1 item), and negative impact of others' opioid misuse (1 item). Sample items include “How difficult or easy would it be for you to get some heroin, if you wanted some?” and “How much do you think people risk harming themselves (physically or in other ways), if they try opioid drugs other than heroin once or twice?” Response scales vary across items (see measure).

Rationale: These items were selected due to their relative simplicity and brevity, use in large-scale surveys of drug use (e.g., Monitoring The Future, National Survey on Drug Use and Health), and appropriateness for use with adolescents.

Cautions: This survey is not an exhaustive list of factors that may influence risk that a youth will misuse opioids. Youth mentoring programs specifically targeting opioid risk or opioid misuse should consider conducting a more comprehensive assessment of risk (e.g., psychological distress, other substance use).  Items addressing opioid misuse by others and its potential impact on youth were developed for purposes of this measure and thus have not been field tested or assessed for reliability or validity.

Special administration information: None.

How to score: There is no total or aggregate score created. Users of the measure should examine responses to individual items to facilitate understanding of risk reported by individual youth or groups of youth.

How to interpret findings: Responses indicating doctor prescription of opioids at an earlier age, greater access to opioids, less perceived risk of harm associated with opioid use, and opioid use by others (e.g., friends, parents) may indicate greater risk for opioid misuse by the youth. Reports of being negatively impacted by others' opioid use, furthermore, indicate a potential for youth to be harmed by opioid use occurring in their family, peer, and community environments.

Access and permissions: A copy of the measure can be found here. The measure is available for non-commercial use with no charge.

Alternatives: The Screener Opioid Assessment for Patients with Pain-Revised (SOAPP-R) is a measure of risk for opioid medication misuse (Butler, Fernandez, Benoit, et al., 2008) and may be a good alternative to the current measure for use with young adults or adults. The 24 items are rated from 0 (“never”) to 4 (“very often”) by respondents based on frequency of occurrence. Total scores range from 0 to 96. Scores ≥ 18 indicate high risk for opioid misuse. It should be kept in mind that this measure was validated with pain patients and thus broader applicability to other populations remains to be established. A copy of the measure can be found here.


Arthur, M. W., Hawkins, J. D., Pollard, J. A., Catalano, R. F., and Baglioni Jr., A. J. (2002). Measuring risk and protective factors for substance use, delinquency, and other adolescent problem behaviors: The Communities That Care Youth Survey. Evaluation Review, 26, 575–601. doi: 10.1177/0193841X0202600601 

Center for Behavioral Health Statistics and Quality. (2018). 2019 National Survey on Drug Use and Health (NSDUH): CAI Specifications for Programming (English Version). Substance Abuse and Mental Health Services Administration, Rockville, MD. Retrieved from https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHmrbCAISpecs2019.pdf

Glaser, R. R., Van Horn, M. L., Arthur, M. W., Hawkins, J. D., & Catalano, R. F. (2005). Measurement properties of the Communities That Care® youth survey across demographic groups. Journal of Quantitative Criminology, 21, 73-102. doi: 10.1007/s10940-004-1788-1

Kecojevic, A., Wong, C. F., Schrager, S. M., Silva, K., Bloom, J. J., Iverson, E., & Lankenau, S. E. (2012). Initiation into prescription drug misuse: Differences between lesbian, gay, bisexual, transgender (LGBT) and heterosexual high-risk young adults in Los Angeles and New York. Addictive Behavior, 37, 1289-1293. doi: 10.1016/j.addbeh.2012.06.006

 Miech, R. A., Johnston, L. D., O’Malley, P. M., Bachman, J. G., Schulenberg, J. E., & Patrick, M. E. (2019). Monitoring the Future national survey results on drug use, 1975–2018: Volume I, Secondary school students. Ann Arbor: Institute for Social Research, The University of Michigan. Available at http://monitoringthefuture.org/pubs.html#monographs


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