title: Social Influence on Adolescent Polysubstance Use: The Escalation to Opioid Use.
abstract: BACKGROUND
  Fewer than 9% of 12-17 year olds in need (∼146,000 of 1.7 million) receive inpatient or outpatient substance abuse recovery services or other mental health services (SAMHSA, 2012). The literature on adolescent addiction is sparse, however, as most published addiction recovery efforts involve adult populations-often college students.
  
  
  OBJECTIVE
  The present study examined social influences on escalating substance use (from tobacco, alcohol, and marijuana use to polysubstance use involving opioids) for students enrolled in recovery high schools.
  
  
  METHODS
  A sample of 31 adolescents enrolled in substance use recovery high schools were surveyed on their patterns of substance use leading to their abuse of opioids.
  
  
  RESULTS
  Youth who begin their substance use as young as age 8 are often pressured by peer culture to do so and come from substance-using families. Their escalation in polysubstance use to a pattern including opioids was also most often attributed to peer influence over several years. Conclusions/Importance: This paper is one of scant few that address patterns of use in high school students. Perhaps most salient from this study are the tertiary prevention implications: similar to their adult counterparts, students enrolled in recovery high school programs are likely from substance-using families and have combined complex constellations of substances including opioids by dint of their relationships with substance-using peers.
authors.affiliation: a Human Development & Family Studies, University of Connecticut , Storrs , Connecticut , USA.
authors.forename: Beth Shoshana
authors.initials: BS
authors.lastname: Russell
authors.affiliation: b Health Economics and Outcomes Research , Boehringer Ingelheim, Ridgefield , Connecticut , USA.
authors.forename: Jeremiah J
authors.initials: JJ
authors.lastname: Trudeau
authors.affiliation: c HDFS, University of Connecticut , Storrs , Connecticut , USA.
authors.forename: Alicia J
authors.initials: AJ
authors.lastname: Leland
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000428:Alcohol Drinking / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008385:Marijuana Smoking / Q000523:psychology*; D009293:Opioid-Related Disorders / Q000150:complications / Q000523:psychology*; D010379:Peer Group; D012907:Smoking / Q000523:psychology*; D012927:Social Control, Informal; D013334:Students / Q000523:psychology
keywords: adolescent addiction; opioid use; social influences; substance use recovery