A Cross Sectional Study of Non-Medical Use of Prescription Opioids and Suicidal Behaviors Among Adolescents

Details

• Personal Author:
  Ramirez MR ; Wright N
• Description:
  Background: Non-medical use of prescription opioids (NMUPO), defined as taking an opioid in a manner or dose other than prescribed, taking someone else's, or for the feelings that it produces, has been reported by 5 to 20% of adolescents, and is associated with a two fold increase in suicidal behaviors among adolescents. Adolescents with long-term health problems (LTHP) have poorer mental health and may seek NMUPO for pain relief that is not obtained through standard care. For this study, we measured the association between NMUPO and suicidal behaviors, and further assessed effect modification by LTHP hypothesizing the association between NMUPO and suicidal behaviors was stronger for adolescents with LTHP. Findings: For students with LTHP, 13.5% reported suicide ideation, while 8.0% of students without LTHP reported suicide ideation. For suicide attempt, 4.4% of students with LTHP reported a suicide attempt, while 2.1% of students without LTHP reported a suicide attempt. The proportion of students who reported suicide ideation and attempts increased with higher occasions of NMUPO. Adjusted logistic regression models found increased odds of suicide ideation (OR (95% CI): 1-5 occasions: 2.3 (2.0-2.6); > 6 occasions: 2.7 (2.2-3.8)) and suicide attempts (OR (95% CI): 1-5 occasions: 3.2 (2.7-3.7); > 6 occasions: 4.1 (3.1-5.3)) for students who reported NMUPO. An interaction term for NMUPO and LTHP was then added to the models. Effect modification was not present on the multiplicative scale. On the additive scale, evidence of effect modification was observed: higher risk was indicated for students with LTHP versus no LTHP for both suicide ideation (Predicted risk (95%CI): > 6 occasions NMUPO, LTHP: 0.24 (0.18-0.29); No LTHP: 0.16 (0.13-0.18)) and attempt (Predicted risk (95%CI): 1-5 occasions NMUPO, LTHP: 0.08 (0.07-0.10); No LTHP: 0.05 (0.05-0.06); > 6 occasions NMUPO, LTHP: 0.11 (0.07-0.15); No LTHP: 0.06 (0.05-0.08)). Conclusions: The results affirmed that NMUPO is associated with suicidal behaviors among adolescents. A pattern also emerged of higher risk of suicidal behaviors for those with LTHP who reported NMUPO. Areas of further inquiry should explore chronic medical or pain conditions as possible modifying pathways that could exacerbate the effects of NMUPO on suicidal behaviors specific to an adolescent population. [Description provided by NIOSH]
• Subjects:
  Adolescent Behavior Mental Health Nervous System Occupational Health Safety Suicide
• Keywords:
  Adolescents Analgesics Attempted Author Keywords: Adolescent Drugs Health Effects Humans Mental Health Models Opioid Pain Statistical Analysis Suicidal Ideation

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• ISSN:
  2197-1714
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Minnesota ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  36
• Volume:
  8
• NIOSHTIC Number:
  nn:20063108
• Citation:
  Inj Epidemiol 2021 Jul; 8:36
• Contact Point Address:
  Nate Wright, Division of Environmental Health Sciences, School of Public Health, 1215-1 Mayo, 420 Delaware Street SE, Minneapolis, MN 55455
• Email:
  wrigh707@umn.edu
• Federal Fiscal Year:
  2021
• Performing Organization:
  University of Minnesota Twin Cities
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Injury Epidemiology
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:25087dda74f9cce3b120a652d3e04d241e11a808b8bfded5d72b63dfb49a9aea8292244f415be4927d58ec5a1f6549bb3a87db8924495e903b7a93c8da43e754
• Download URL:
  https://stacks.cdc.gov/view/cdc/226231/cdc_226231_DS1.pdf
• File Type:
  [PDF - 568.54 KB ]