title: Family ties: maternal-offspring attachment and young adult nonmedical prescription opioid use.
abstract: BACKGROUND
  Nonmedical prescription drug use is prevalent among young adults, yet little is known about modifiable determinants of use. We examined whether maternal-offspring attachment reported at mean age 21 was associated with nonmedical prescription opioid use at mean age 26, and investigated whether a history of depressive symptoms and substance use played a role in associations between maternal-offspring attachment and nonmedical prescription opioid use.
  
  
  METHODS
  We used data from the Growing Up Today Study, a longitudinal cohort of United States adolescents followed into young adulthood. Maternal-offspring attachment was reported by young adults and their mothers, and defined as mutual low, mutual medium or high, and dissonant. Analyses were carried out in the full sample using generalized estimating equation models, and in a sibling subsample, using conditional fixed effects models to control for stable aspects of the family environment.
  
  
  RESULTS
  Analyses with the full sample and the sibling subsample both showed that mutual medium/high maternal-offspring attachment at age 21 was associated with lower odds of nonmedical prescription opioid use at age 26 (RR=0.74; 95% CI=0.57-0.97 in full sample). The association was partly mediated by mean age 23 offspring smoking, heavy episodic drinking, and illicit drug use.
  
  
  CONCLUSIONS
  Promoting reciprocal attachment in the maternal-offspring dyad should be investigated as a strategy to prevent nonmedical prescription opioid use by young adulthood. Even in young adulthood, programs that target both parents and offspring may have greater impact on offspring substance use than programs that target offspring alone.
authors.affiliation: Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY 10032, USA. Electronic address: mc3226@columbia.edu.
authors.forename: M
authors.initials: M
authors.lastname: Cerdá
authors.affiliation: Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY 10032, USA.
authors.forename: P
authors.initials: P
authors.lastname: Bordelois
authors.affiliation: Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY 10032, USA.
authors.forename: K M
authors.initials: KM
authors.lastname: Keyes
authors.affiliation: Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston MA 02115, USA.
authors.forename: A L
authors.initials: AL
authors.lastname: Roberts
authors.affiliation: Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY 10032, USA.
authors.forename: S S
authors.initials: SS
authors.lastname: Martins
authors.affiliation: Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston MA 02115, USA; Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA.
authors.forename: S L
authors.initials: SL
authors.lastname: Reisner
authors.affiliation: Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston MA 02115, USA; Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA 02115, USA; Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA; Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
authors.forename: S B
authors.initials: SB
authors.lastname: Austin
authors.affiliation: Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA 02115, USA; Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA; Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
authors.forename: H L
authors.initials: HL
authors.lastname: Corliss
authors.affiliation: Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY 10032, USA.
authors.forename: K C
authors.initials: KC
authors.lastname: Koenen
mesh_terms: D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009034:Mother-Child Relations / Q000523:psychology*; D009769:Object Attachment; D009293:Opioid-Related Disorders / Q000523:psychology*; D063487:Prescription Drug Misuse / Q000523:psychology*; D012907:Smoking / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid
keywords: Maternal-child attachment; Mediators; Nonmedical prescription opioid use; Sibling fixed effects models