Opioid misuse among high schoolers associated with increased risk for suicidal behaviors

Current and past prescription opioid misuse were associated with increases in the risk for suicide-related behaviors and experiences among U.S. high schoolers, according to data published in Pediatrics.

Natalie J. Wilkins, PhD, a behavioral scientist at the CDC, and colleagues calculated prevalence estimates of prescription opioid misuse and suicide risk behaviors in the past 12 months among high school students. Behaviors included persistent feelings of sadness or hopelessness, serious consideration of suicide attempt, suicide planning and suicide attempts.

The authors obtained data on 13,677 U.S. high school students who participated in the 2019 National Youth Risk Behavior Survey.

Among all students, 7.4% reported past prescription opioid misuse, whereas 7.2% reported current misuse. Additionally, 37.4% of students reported feeling sad or hopeless, 19% reported seriously contemplating suicide, 16.1% had made a suicide plan and 8.9% had attempted suicide.

The authors reported that 44.4% of students who reported current prescription opioid misuse had also reported that they had seriously contemplated suicide. Of those, 39.4% had made a suicide plan, and 32.5% had attempted suicide. Furthermore, 65.4% of them had reported feeling sad or hopeless in the last 12 months.

Of those who had reported past opioid misuse, 37.2% had considered a suicide attempt and 32.6% had made a suicide plan, whereas 18.7% had made a suicide attempt. Of those, 57.4% had reported feeling sad or hopeless in the last 12 months.

Among those who reported no opioid misuse, 15.3% had seriously considered a suicide attempt, 12.7% had made a suicide plan and 6% had attempted suicide. Of these students, 33.4% reported feeling sad or hopeless in the past 12 months.

Those reporting current misuse had the highest adjusted prevalence ratio for suicide ideation (2.3; 95% CI, 1.97-2.69), suicide planning (2.33; 95% CI, 1.99-2.79), suicide attempts (3.21; 95% CI, 2.56-4.02), as well as feeling sad or hopeless (1.59; 95% CI, 1.37-1.84).

“These findings suggest that identifying youth who are struggling with current [prescription opioid misuse] and connecting them with substance use treatment and services could be a critical approach for preventing youth suicide,” the authors wrote. “The findings from this analysis also suggest that although youth who report current [prescription opioid misuse] may be at highest risk for suicide risk behaviors and experiences, all youth who report [prescription opioid misuse] in their lifetime are at an elevated risk.”