Arnold, BrentHurse, Deidre N.Altenburger, PeterGoering, ElizabethSaha, ChandanAgho, Augustine2019-11-132019-11-132019-10https://hdl.handle.net/1805/21327http://dx.doi.org/10.7912/C2/1406Indiana University-Purdue University Indianapolis (IUPUI)The United States is amidst an opioid overdose epidemic. Even with significant gaps in surveillance data on opioid-related deaths, the problem is undeniable and requires a systemic response. Despite the dangerous effects of opioid misuse, pathways that lead to opioid abuse for young people is understudied. This study sought to understand factors related to opioid misuse among youth. An exploratory approach used data from both quantitative and qualitative sources. The convergent parallel mixed method design used secondary data from a biannual school-based survey and three oral interviews. While opioid misuse is not limited to heroin, the 2013, 2015, and 2017 Youth Risk Behavior Surveillance Survey (YRBS) was used to determine associations between predictor variables and heroin use. Oral interviews added the perspective of adolescent users and were inclusive of persons that misused prescription and other forms of opioids. The synchronization of data analysis allowed observations to impact the study direction unilaterally. Opioid misuse for youth was related to experiences, access, and divergent substance use. Traumatic stressors, such as physical dating violence and sexual dating violence, had the most substantial relationship with heroin misuse. Findings confirmed that ease of access had a relationship with misuse. It is unclear if opioid misuse was a result of polysubstance use. However, the study identified that divergent substance use was correlated with opioid misuse in this population. The study findings support the use of early intervention before high school. Prevention must be inclusive of primary, secondary, and tertiary approaches. Future prevention for youth can be enhanced by addressing resilience from trauma, reducing access to opioids and addressing alcohol, and substance use among youth. Adopting a framework that acknowledges the root causes of misuse, can mitigate the impact of the opioid crisis and save lives.en-USDissertation