The impact of stepfamily relationship quality on emerging adult non-medical use of prescription drugs


Emerging adults, non-medical use of prescription drugs, stepfamily relationships


Background: Emerging adults aged 18 to 25 are most at-risk for non-medical use of prescription drugs (NMUPD). While the literature dedicated to emerging-adult NMUPD has explored risk and protective factors at an individual level, much less is known regarding how interpersonal and familial factors relate to NMUPD. Because interpersonal bonds can have a significant impact on behavior, familial factors may be important predictors of NMUPD among emerging adults. Objectives: Inasmuch as growing up in a stepfamily is increasingly common for children, this study aimed to determine whether perceived stepfamily quality within three stepfamily subsystems – child-biological parent, child-stepparent, and child-stepsibling – decreased the likelihood of NMUPD in emerging adulthood. Methods: Data came from the Stepfamily Experiences Project (STEP), a retrospective survey examining emerging adults’ perceptions of their stepfamily life in 2013. A national quota sampling strategy was used, and the final sample consisted of 902 emerging adults (54.1% female). A structural equation model was constructed, with regression paths from each latent construct predicting the ordinal dependent variable, NMUPD. Results: Increased retrospective biological parent relationship quality in childhood significantly decreased the likelihood of intensifying NMUPD in emerging adulthood (e.g. moving from the “None” category to the “Once a month or less” category). However, stepparent and stepsibling relationship quality did not influence NMUPD. Conclusion: Findings underscore the importance of the preservation of the child-biological parent relationship within a stepfamily context, and encourage further research on the impact familial systems and subsystems may have on NMUPD.

Original Publication Citation

Ward, K., Dennis, C. B., & Limb, G. E. (2018). Stepfamily relationship quality and its impact on emerging adult non-medical use of prescription drugs. The American Journal of Drug and Alcohol Abuse, 44(4), 463-471.

Document Type

Peer-Reviewed Article

Publication Date



The American Journal of Drug and Alcohol Abuse




Family, Home, and Social Sciences


Social Work

University Standing at Time of Publication

Assistant Professor