Social Science Research Institute, Duke University, Durham, North Carolina, USA.
Subst Use Misuse. 2024;59(13):1930-1937. doi: 10.1080/10826084.2024.2392504. Epub 2024 Aug 18.
The linkage between substance use and youth suicidality is less developed due to the predominant focus on certain types of substances (e.g., alcohol consumption, prescription opioid misuse). This study examines polysubstance use and its mutual impact on suicidal thoughts and behaviors among US adolescents. Data from 2019 Youth Risk Behavior Survey were utilized. Associations between the concurrent use of five substances (cigarette, e-cigarette, alcohol, marijuana, and prescription opioid) and suicidality (suicidal thoughts, suicide plans, and suicide attempts) were measured by logistic regression models. The combined effect of polysubstance use on suicidality was further assessed by structural equation modeling. About two in five (42.1%) adolescents used at least one type of substances in the past month and one in seven (13.5%) used three or more types concurrently (polysubstance use). Adolescents with polysubstance use behaviors were three to five times more likely to experience suicidal thoughts (OR=3.8, < 0.05), make a suicide plan (OR=3.5, < 0.05), or attempt suicide (OR=4.6, < 0.05) than non-users. In the final structural model, polysubstance use and suicidality were significantly correlated with each other (β=0.37, < 0.05). Collectively, polysubstance use explained about 14% of variance in youth suicidality. Polysubstance use shows a significant impact on youth suicidality. School-based health centers and educational programs are recommended to reduce substance use and suicidal behaviors among adolescents. Accessible mental health services and targeted treatments are needed for polysubstance users to mitigate their risk of suicide.
由于主要关注某些类型的物质（例如酒精消费、处方类阿片类药物滥用），物质使用与青年自杀意念之间的联系还不太明确。本研究考察了美国青少年中多物质使用及其对自杀意念和行为的相互影响。研究数据来自 2019 年的青少年风险行为调查。使用逻辑回归模型来衡量五种物质（香烟、电子烟、酒精、大麻和处方类阿片）同时使用与自杀意念（自杀想法、自杀计划和自杀尝试）之间的关联。通过结构方程模型进一步评估多物质使用对自杀意念的综合影响。大约五分之二（42.1%）的青少年在过去一个月至少使用过一种物质，七分之一（13.5%）的青少年同时使用三种或更多种物质（多物质使用）。有多种物质使用行为的青少年更有可能经历自杀想法（OR=3.8，<0.05）、制定自杀计划（OR=3.5，<0.05）或尝试自杀（OR=4.6，<0.05），而非非使用者。在最终的结构模型中，多物质使用和自杀意念之间存在显著相关性（β=0.37，<0.05）。总的来说，多物质使用可以解释青少年自杀意念 14%的变异。多物质使用对青少年自杀意念有显著影响。建议在学校建立健康中心和教育项目，以减少青少年的物质使用和自杀行为。需要为多物质使用者提供可及的心理健康服务和有针对性的治疗，以降低他们的自杀风险。
