Prescription Opioid Misuse and Suicide Risk Behaviors Among High School Students

1. Data culled from the 2019 National Youth Risk Behavior Survey (YRBS) indicates increased adjusted incidence rates of all suicide risk behaviors with increasing recency of prescription opioid misuse (POM).

2. The established intersection between prescription opioid misuse and suicide rates provides a rational primary point of focus to mitigate the burgeoning public health issue of teen suicide.

Evidence Rating Level: 2 (Good)

Study Rundown: Increased access to prescription opioids has led to a 250% increase in opioid-related deaths among youths aged 15-19 years from 1999-2016, with a total of 14.6% of high school students having abused opioids at some point in their lives. This study used data from the 2019 YRBS to examine whether a correlation exists between opioid use and suicide risk behaviors in a group of over 13,000 adolescents. Adjusted analysis showed that students who reported current POM exhibited the highest rate of suicide risk behaviors across every category, followed by students who reported past POM, and trailed distantly by students who had no reported history of POM use. This study improved on previous studies by elaborating on the difference between current and past use of POM. Limitations include cross-sectional study design and the fact that severity of POM abuse was not specified. Results of this study should encourage a focus of suicide prevention efforts preferentially towards adolescents currently misusing prescription opioids, followed by past-users, and then never-users.

Click to read the study in Pediatrics

Relevant Reading: Examining the association between prescription opioid misuse and suicidal behaviors among adolescent high school students in the United States

In-Depth [cross-sectional study]: A 3-level composite variable was utilized (comparing current POM use, past POM use, and never having used POM) in analyzing data from the 2019 YRBS, and further adjusted with covariables including sex, race/ethnicity, sexual identity, concurrent substance abuse (alcohol, marijuana, illicit drugs). An estimated 7.4% of U.S. students reported past POM (19% of whom attempted suicide), and 7.2% reported current POM (~33% of whom attempted suicide) in 2019. Students who reported current POM had the highest adjusted prevalence ratios (aPRs) for suicidal ideation (aPR: 2.30; 95% confidence interval [CI] 1.97–2.69), planning (aPR: 2.33; 95% CI 1.99–2.79), attempts (aPR: 3.21; 95% CI 2.56–4.02), and feeling sad or hopeless (aPR: 1.59; 95% CI 1.37–1.84). Compared to male students and heterosexual students, female and LGBT students, respectively, experienced elevated rates of POM and suicide risk behavior.

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