Opioid Misuse

Scale: Youth Risk Behavior Survey Questionnaire (YRBS) from the Youth Risk Behavior Surveillance System - Opioid misuse items

What it measures:

  • Lifetime and 30-day misuse of prescription pain medication and heroin.

Intended age range: The items are intended for use with middle and high school students.

Brief description: The YRBS includes three questions on opioid use: lifetime misuse of prescription pain medication (i.e., “use of prescription pain medicine without a doctor’s prescription or differently than how a doctor told you to use it”); 30-day misuse of prescription pain medication; and lifetime heroin use. Each item is rated on a 6-point scale: 0 times; 1 or 2 times; 3 to 9 times; 10 to 19 times; 20 to 39 times; 40 or more times. 

Rationale: This measure was selected based on its brevity, appropriateness for use with youth, coverage of use of different types of opioids, availability of national norms, and evidence of validity. 

Cautions: This measure does not include pictures of different pain medications, which could help youth distinguish among types of prescription medication (e.g., opioids versus methamphetamines). It also does not assess accidental exposure to opioid drugs, such as might occur through use of a substance that is contaminated with an opioid drug.

Special administration information: The items could be adapted to assess use of specific opioids, such as by replacing “prescription pain medicine” with the name of specific drugs of interest.  However, such items are not included on the YRBS and thus validity data and national norms would not be available.

How to score: Each item is scored from 1 (0 times) to 6 (40 or more times) to yield three descriptive measures of opioid misuse.

How to interpret findings: Higher scores indicate more frequent opioid misuse.

Access and permissions: The YRBS is available for use with no charge and is available here. The specific questions on opioid misuse are available here

Alternatives: The Monitoring the Future survey includes questions asking about 30-day and/or 12-month use of specific opioids, including OxyContin, Vicodin, non-prescription cough or cold medicine, and heroin. The full survey codebook for the 8th and 10th grade surveys can be found here.  The National Institute on Drug Abuse has also created a screener to assist clinicians serving adult patients in screening for drug use, that appears potentially appropriate for use with adolescents. The screener asks about frequency of opioid (and other drug) use and follows with questions designed to assess risk for having or developing a substance use disorder and suggested next steps. Information on the screener can be found here.

Citation: Centers for Disease Control and Prevention (2018). 2019 Youth Risk Behavior Survey Questionnaire. Retrieved from www.cdc.gov/yrbs.


More in this category: « Youth-Centered Outcomes

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