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Nonmedical use of prescription opioids, psychological distress, and suicidality among adolescents

Abstract

Purpose

The present study examined associations between nonmedical use of prescription opioids and serious psychological distress, suicidal ideation, and suicide attempts, and tested whether age and sex moderate these relationships.

Methods

Data on 5582 adolescents were obtained from a representative province-wide survey of students in grades 7 through 12 (mean age: 15.3 years) across Ontario, Canada. Nonmedical use of prescribed opioids in the last 12 months was categorized in “no use”, “infrequent use (1–2 times)”, and “regular use (3 times or more)”. Logistic regression analysis was adjusted for age, sex, ethnicity, subjective socioeconomic status, and other substance use (i.e., tobacco cigarette, alcohol, cannabis).

Results

Overall, regular nonmedical use of prescription opioids was strongly associated with greater odds of serious psychological distress (OR: 3.47; 95% CI 1.42–8.45), suicidal ideation (OR: 2.73; 95% CI 1.84–4.05), and suicide attempts (OR: 3.21; 95% CI 1.40–7.37). However, infrequent nonmedical use of prescription opioids was associated with greater odds of serious psychological distress (OR: 1.79; 95% CI 1.08–2.98) and suicidal ideation (OR: 1.63; 95% CI 1.20–2.21), but not suicide attempts (OR: 1.84; 95% CI 0.76–4.45). Age-stratified analyses showed that both infrequent (OR: 1.61; 95% CI 1.01–2.58) and regular (OR: 3.40; 95% CI 2.11–5.46) nonmedical use of prescription opioids was strongly associated with greater odds of suicidal ideation among 15- to 20-year-olds, but not 11- to 14-year-olds.

Conclusion

These findings suggest that nonmedical use of prescription opioids is strongly associated with mental health problems among adolescents. Future research using a longitudinal design is needed to confirm age differences and temporality.

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Data availability

Our data cannot be made available in the manuscript, the supplemental files or a public repository due to the Centre for Addiction and Mental Health’s and The Ontario Public and Catholic School Board’s institutional Research Ethics Board agreements. Qualified, interested researchers may request access to the data at the Centre for Addiction and Mental Health.

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Acknowledgements

The Ontario Student Drug Use and Health Survey, a Centre for Addiction and Mental Health initiative, was funded in part through ongoing support from the Ontario Ministry of Health and Long-Term Care, as well as targeted funding from several provincial agencies.

Funding

This research paper was partly supported by the Research Council of Norway through its Centres of Excellence funding scheme, project number 262700 for Ian Colman. The funders had no involvement in study design; collection, analysis, and interpretation of data; writing the report; or the decision to submit the report for publication.

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Correspondence to Hugues Sampasa-Kanyinga.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

The 2017 OSDUHS protocol was approved by the Research Ethics Boards at the Centre for Addiction and Mental Health and York University, as well as school board research review committees. The study was conducted in accordance with ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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All participants gave informed consent.

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All participants provided their own consent in addition to parental signed consent.

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Sampasa-Kanyinga, H., Bakwa-Kanyinga, F., Chaput, JP. et al. Nonmedical use of prescription opioids, psychological distress, and suicidality among adolescents. Soc Psychiatry Psychiatr Epidemiol 56, 783–791 (2021). https://doi.org/10.1007/s00127-020-01958-x

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  • DOI: https://doi.org/10.1007/s00127-020-01958-x

Keywords

  • Analgesics
  • Pain relievers
  • Mental health
  • Suicidal behaviour
  • Suicidal ideation
  • Suicide attempts