Associations between childhood maltreatment and non-medical use of prescription drugs among Chinese adolescents

Aims To test, among Chinese adolescents: (1) whether childhood maltreatment is associated with non-medical use of prescription drugs (NMUPD) and (2) whether there are interaction effects of childhood maltreatment and depressive symptoms on NMUPD. Design A secondary analysis of the cross-sectional data collected from 7th- and 12th-graders who were sampled using a multi-stage, stratified-cluster, random-sampling method in the 2015 School-based Chinese Adolescents Health Survey (SCAHS). Setting Surveys conducted in high schools in six cities of China in 2015. Participants There were 24 457 students who were invited to participate and 23 039 students' questionnaires were completed and qualified for our survey. Measurements The outcomes comprised self-report of NMUPD (prior 30 days); a history of childhood maltreatment was our main predictor. Other covariates included depressive symptoms, smoking, drinking and demographics. Data were analysed using multi-level regression modelling. Findings Our final multivariable logistic regression models demonstrated that after adjusting for other variables, physical abuse was associated positively with non-medical use of opioids [adjusted odds ratio (AOR) = 1.13, 95% confidence interval (CI) = 1.10-1.22], sedatives (AOR = 1.11, 95% CI = 1.10-1.21) and any prescription drugs (AOR = 1.13, 95% CI = 1.09-1.20); emotional abuse, sexual abuse and emotional neglect were also associated with an increased risk of opioids, sedatives and any prescription drugs misuse; students who reported that they had experienced childhood physical neglect were more likely to be involved in the non-medical use of sedatives (AOR = 1.08, 95% CI = 1.04-1.12) and any prescription drugs (AOR = 1.06, 95% CI = 1.03-1.10). Additionally, there was no evidence of interaction effects on NMUPD between depressive symptoms and each of physical abuse, emotional abuse, sexual abuse, physical neglect and emotional neglect, respectively. Conclusions Maltreatment while a child is associated with an increased risk of non-medical use of prescription drugs (NMUPD) among Chinese adolescents. The interactions of maltreatment while a child and depressive symptoms do not appear to be associated significantly with NMUPD among Chinese adolescents.