Shaping Prevention through the Voices of Emerging Young Adults: Social and Situational Contexts of Opioid Use

Written by Cynthia G. Ayres & Mary Wunnenberg

doi: https://doi.org/10.13178/jnparr.2026.1601.1604

Abstract

Background: Opioid misuse remains a leading public health crisis in the United States, disproportionately impacting teens and young adults. Despite the implementation of school-based prevention programs, the rates of misuse continue to increase, underscoring the need for innovative, youth-centered approaches to address this issue.

Objective: To explore the social and situational contexts surrounding opioid initiation,continuation, and recovery among emerging young adults to inform the design of future opioid prevention interventions.

Methods: Three focus groups (N = 30, aged 18–25, opioid-free for ≥ 30 days) were conducted in collaboration with two community-based organizations in southern New Jersey that serve individuals affected by substance use. The data were analyzed using content analysis and guided by Social Cognitive Theory (SCT).

Results: Peers normalize opioid use, and individuals often begin using them through family prescriptions, peer influence, or curiosity. Continuation of use was driven by coping with trauma, avoidance of withdrawal, and pursuit of the first high. Participants described consequences that included broken relationships, financial and legal troubles, overdose, and stigma. Traditional prevention programs (e.g., DARE) were viewed as ineffective, whereas peer-led, authentic, and culturally relevant approaches were valued.

Conclusion: Effective prevention strategies should include peer modeling, authenticity, and cultural sensitivity to be impactful. SCT provides a valuable framework for designing social media–based interventions co-created with youth.

Keywords: adolescents, opioids, prevention, focus groups, Social Cognitive Theory, stigma