Nonmedical use of prescription opioids, psychological distress, and suicidality among adolescents
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ORIGINAL PAPER
Nonmedical use of prescription opioids, psychological distress, and suicidality among adolescents Hugues Sampasa‑Kanyinga1 · Felly Bakwa‑Kanyinga2 · Jean‑Philippe Chaput1,3 · Hayley A. Hamilton4,5 · Tara Elton‑Marshall4,5 · Ian Colman1,6 Received: 10 March 2020 / Accepted: 1 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
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. Keywords Analgesics · Pain relievers · Mental health · Suicidal behaviour · Suicidal ideation · Suicide attempts
Introduction * Hugues Sampasa‑Kanyinga [email protected] 1
School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON K1G 5Z3, Canada
2
Department of Social and Preventive Medicine, Laval University, Quebec City, QC, Canada
3
Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
4
Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
5
Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
6
Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
The increase in nonmedical use of prescription opioids among adolescents over the past
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