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Nonmedical use of prescription drugs may increase risk for suicide in students

Nonmedical use of prescription drugs was associated subsequent suicidal ideation and attempts among adolescent students in China, according to recent findings.

“Although drug use is a known correlate of suicidality, there is a relative dearth of studies on the relationships between [nonmedical use of prescription drugs], suicidal ideation, and suicidal attempts. Furthermore, most prior studies on this topic used a cross-sectional design, and could not determine whether [nonmedical use of prescription drugs] preceded suicidality,” Lan Guo, MD, of Sun Yat-sen University, Guangzhou, People’s Republic of China, and colleagues wrote.

To determine associations between nonmedical use of prescription drugs, suicidal ideation and attempts and depressive symptoms among adolescents, researchers surveyed 3,273 students from schools in Guangzhou from 2009 to 2010. Study participants had a mean age of 13.7 years.

When controlling for sociodemographic information, depressive symptoms, alcohol-related problems, suicidal ideation and attempts, opioids misuse (adjusted OR = 2.31; 95% CI, 1.3-4.11), sedatives misuse (aOR = 4.46; 95% CI, 1.54-7.94), and nonmedical use of any prescription drug (aOR = 1.97; 95% CI, 1.21-3.23) at baseline were positively associated with suicidal ideation at follow-up.

When controlling for sex, age, household socioeconomic status, living arrangements, depressive symptoms, alcohol-related problems, suicidal ideation, and suicidal attempts at baseline, baseline opioid misuse (aOR = 3.39; 95% CI, 1.33-5.63) and nonmedical use of any prescription drug (aOR = 2.91; 95% CI, 1.26-3.71) were associated with subsequent suicidal attempts.

Researchers found significant standardized indirect effects of baseline opioids misuse on subsequent suicidal ideation and suicidal attempts through depressive symptoms.

Further, the standardized indirect effect of baseline sedatives misuse on subsequent suicidal ideation through depressive symptoms was also significant.

“Our study identified that baseline nonmedical use of opioids was significantly associated with suicidal ideation and suicidal attempts at follow-up, baseline nonmedical use of sedatives was related to suicidal ideation at follow-up, and baseline nonmedical use of any prescription drug was also associated with subsequent suicidal ideation and suicidal attempts. Moreover, depressive symptoms significantly partially mediated those significant relationships,” the researchers wrote. “First, educational campaigns directed at students are needed to improve their awareness of the serious consequences of [nonmedical use of prescription drugs]. Second, we should pay close attention to the adolescents who have depressive symptoms, are involved in [nonmedical use of prescription drugs], or have suicidal thoughts or attempts. Third, a proper surveillance system needs to be developed by learning from the experiences of the [National Survey on Drug Use and Health] in the United States to control and oversee the [nonmedical use of prescription drugs] and suicidality among Chinese adolescents.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.