Cance Jessica Duncan, Hairgrove Sara, Saavedra Lissette M, Bonar Erin E, Walton Maureen A, Patel Sheila V, Yule Amy M, King Cheryl, Chavez Laura J, Slesnick Natasha, Fernandes Claudia-Santi F
RTI International, Research Triangle Park, North Carolina.
Substance Abuse and Mental Health Services Administration, Rockville, Maryland.
J Adolesc Health. 2025 May;76(5):781-797. doi: 10.1016/j.jadohealth.2024.10.026. Epub 2025 Feb 13.
The purpose of this systematic review is to assess evidence for an association between opioid misuse and suicide-related outcomes among youth and young adults (aged 12-30 years). A Boolean search strategy of eligible publications from January 1990 to June 2024 identified 2,696 independent citations. An additional 10 were identified through reference screening. A total of 55 publications met the inclusion criteria. Twelve studies used administrative data and 43 were based on observational data. Risk of bias was assessed qualitatively by domain. Nearly all (98%) studies using observational data found an association between opioid misuse and at least one suicide-related outcome (e.g., suicidal ideation, suicide plan, suicide attempt). Administrative data studies had higher risk of bias compared with observational studies, typically due to higher confounding bias. Reporting bias was moderate to high across all studies in the review. Our review provides clear evidence of the association between opioid misuse and suicide-related outcomes among youth and young adults. However, we highlight a need for longitudinal research on the directionality of the association and potential mechanisms.
本系统评价的目的是评估青少年和青年（12至30岁）阿片类药物滥用与自杀相关结局之间关联的证据。通过对1990年1月至2024年6月符合条件的出版物进行布尔检索策略，共识别出2696条独立引文。通过参考文献筛选又识别出10条。共有55篇出版物符合纳入标准。12项研究使用行政数据，43项基于观察性数据。通过领域对偏倚风险进行定性评估。几乎所有（98%）使用观察性数据的研究都发现阿片类药物滥用与至少一种自杀相关结局（如自杀意念、自杀计划、自杀未遂）之间存在关联。与观察性研究相比，行政数据研究的偏倚风险更高，通常是由于混杂偏倚更高。在本评价的所有研究中，报告偏倚为中度至高度。我们的评价提供了明确证据，证明青少年和青年中阿片类药物滥用与自杀相关结局之间存在关联。然而，我们强调需要对该关联的方向性和潜在机制进行纵向研究。
