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Parental opioid use increases risk for child suicide attempt

Parental prescription opioid use appeared associated with greater risk for suicide attempt among offspring, according to study results published in JAMA Psychiatry.

“To date, there has been little focus on the association of parental opioid abuse with the risk suicidal behavior by their offspring,” David A. Brent, MD, the department of psychiatry University of Pittsburgh, and colleagues wrote. “Such a link is plausible because parental substance abuse is a well-known risk factor for offspring suicide attempts and because other parental conditions that also predispose their offspring to suicidal behavior, including depression and suicide attempt, are more common among adults who abuse opioids.”

Brent and colleagues examined the link between parental use of prescription opioids (defined as having received more than 365 days of opioid medications 20102016) and the increasing rate of youth suicide attempt in this 6-year, pharmacoepidemiologic study. They compared the suicide attempt rate among the children of parents who used opioids and those who did not.

MarketScan medical claims data privately insured people in the U.S. yielded 121,306 propensity score–matched parents aged 3050 years who used opioids and those who did not, and their children aged 1019 years (184,142 children of parents who used opioids and 148,395 children of parents who did not).

Analysis revealed that parental opioid use doubled the risk suicide attempt by their offspring (OR = 1.99; 95% CI, 1.71-2.33). Children of parents who took opioids compared with the children of matched controls had suicide attempt rates of 11.68 vs. 5.87 per 10,000 person-years.

The results showed that this link remained significant after the researchers adjusted for child age and sex (OR = 1.85; 95% CI, 1.58-2.17), added child and parental depression and substance use disorder diagnoses (OR = 1.46; 95% CI, 1.24-1.72) and added parental history of suicide attempt (OR = 1.45; 95% CI, 1.23-1.71). In addition, the association was unchanged based on geographical variation in opioid use (OR = 2; 95% CI, 1.71-2.34).

Brent and colleagues also found that diagnosis of opioid use disorder (OUD) was low among parents who had more than 1 year of opioid use, with only 4.4% of the parents using opioids receiving treatment with buprenorphine.

“Helping the families of parents with OUD depends on identifying OUD in the parents,” they wrote. “Recognition and treatment of parents with OUD, attendance to comorbid conditions in affected parents, and screening and appropriate referral of their children may help, at least in part, to reverse the current upward trend in mortality due to the twin epidemics of suicide and opioid overdose.” – by Savannah Demko

Disclosure: Brent reports royalties from eRT, Guilford Press and UpToDate as well as consulting for Healthwise and McKeeson. Please see the study for all other authors’ relevant financial disclosures.