Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia; and
Divisions of Violence Prevention and.
Pediatrics. 2021 Apr;147(4). doi: 10.1542/peds.2020-030601. Epub 2021 Mar 1.
In previous studies, researchers have reported that youth with a lifetime history of prescription opioid misuse (POM) are at an increased risk for suicidal ideation, planning, and attempts. In this study, we investigate whether the association between youth POM and suicide outcomes differs by recency of POM (ie, none, past, or current misuse).
In this report, we use data from the 2019 Youth Risk Behavior Survey to examine associations between recency of POM (current POM, past POM, and no POM) and suicide risk behaviors among US high school students.
After controlling for demographics, alcohol, and other drug use, both current POM and past POM were significantly associated with all suicide risk behaviors compared with no POM. 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). Students who reported current POM also were significantly more likely than youth who reported past POM to report that they had seriously considered attempting suicide, made a suicide plan, and attempted suicide.
Although POM, particularly current POM, is associated with increases in the risk for suicide-related behaviors and experiences of youth, comprehensive prevention approaches that address the intersections between suicide and POM provide a promising path forward for addressing these public health challenges among youth.
在以往的研究中,研究人员报告称,有终生使用处方阿片类药物(POM)史的青少年自杀意念、计划和尝试的风险增加。在这项研究中,我们调查了青少年 POM 与自杀结果之间的关联是否因 POM 的近期使用情况(即无、过去或当前滥用)而有所不同。
本报告使用 2019 年青少年风险行为调查的数据,调查了美国高中生近期 POM(当前 POM、过去 POM 和无 POM)与自杀风险行为之间的关联。
在控制了人口统计学、酒精和其他药物使用情况后,与无 POM 相比,当前 POM 和过去 POM 均与所有自杀风险行为显著相关。报告当前 POM 的学生自杀意念(调整后患病率比 [aPR]:2.30;95%置信区间 [CI]:1.97-2.69)、计划(aPR:2.33;95% CI:1.99-2.79)、尝试(aPR:3.21;95% CI:2.56-4.02)和感到悲伤或绝望(aPR:1.59;95% CI:1.37-1.84)的调整后患病率比最高。报告当前 POM 的学生也比报告过去 POM 的学生更有可能报告他们曾认真考虑过自杀、制定过自杀计划并尝试过自杀。
尽管 POM,特别是当前 POM,与自杀相关行为和经历的风险增加有关,但综合预防方法解决了自杀和 POM 之间的交叉点,为解决青少年面临的这些公共卫生挑战提供了一个有前途的途径。