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Impact of opioid misuse timing on suicidality in teens


Prescription opioid misuse has been linked to suicidality. A study examines whether the timing of the misuse, either past or current, has an impact.

The past several years have been marked with an increase in suicidality in children and adolescents as well as the rise of opioid misuse. Previous studies have shown that a lifetime history of prescription opioid misuse was tied to an increased risk of suicidality, including ideation, planning, and attempts. A report in Pediatrics examines if the tie between prescription opioid misuse and suicide outcomes is changed by the recency of the misuse.1

Investigators used data from the 2019 Youth Risk Behavior Survey. In the survey, high school students were asked how many times they had used prescription pain medicine without a doctor’s prescription for both their lifetime and the past 30 days. They were told to include drugs like Vicodin, OxyContin, hydrocodone, Percocet, and codeine. They were also asked about suicidality in the past 12 months as well as whether they’d experienced a sadness or hopelessness for at least ≥2 weeks that led to stopping the pain medicine activity.

Data on 13,677 students were used in the report. The investigators found that after controlling for alcohol use, other drug use, and demographics, that current and past prescription opioid misuse had significant links to all suicide risk behaviors when compared to no history of prescription opioid misuse. Additionally, the students who reported current prescription opioid misuse were found to have the highest adjusted prevalence ratios (aPRs) for suicidal ideation (aPR: 2.30; 95% 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). When compared to students with past prescription misuse, those who reported current misuse were significantly more likely to report seriously considering a suicide attempt, making a suicide plan, or had attempted suicide.

The investigators concluded that all prescription opioid misuse was linked to increased risk of suicidality in adolescents, particularly if the misuse is current. The findings support the creation and use of prevention approaches that address both suicide and prescription opioid misuse and when they intersect.


1. Wilkins N, Clayton H, Jones C, Brown M. Current prescription opioid misuse and suicide risk behaviors among high school students. Pediatrics. March 1, 2021. Epub ahead of print. doi:10.1542/peds.2020-030601

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