Beyond urban centers: Investigating general strain theory and opioid use among rural adolescents

The opioid epidemic has devastated rural America, including adolescents that reside in these regions, yet studies on that focus on this population remain scarce. This study examined the relationship between various strains and substance use among rural adolescents in the United States, focusing on opioid use during the early stages of the opioid epidemic. Drawing on general strain theory (GST), the research examines the influence of different forms of victimization, homelessness, and poor health status on adolescent opioid use. Data were collected from 4529 adolescents in 27 different states who underwent evaluation for substance abuse treatment in non-metropolitan areas (population less than 250,000). Logistic regression analyses revealed significant associations between several forms of strain and opioid use, with physical victimization, anticipated victimization, emotional victimization, homelessness, and poor health emerging as predictors of opioid use. Additionally, depression and anxiety were found to mediate the relationship between certain strains and substance use. This research contributes to our understanding of the challenges faced by rural adolescents amidst the ongoing opioid crisis and highlight the need for targeted intervention.