title: Adolescent Nonmedical Use of Prescription Pain Relievers, Stimulants, and Depressants, and Suicide Risk.
abstract: BACKGROUND
  Although the link between drug abuse and suicide risk is established, few studies have examined the relationship between the nonmedical use of prescription drugs (NMUPD) and suicide risk, particularly among adolescents.
  
  
  OBJECTIVE
  To explore the relationship between NMUPD and suicide risk among 4,148 adolescents in grades 9-12 enrolled in five public high schools.
  
  
  METHODS
  Logistic regression models were constructed for the nonmedical use of prescription pain relievers, depressants, stimulants, and a composite measure for any NMUPD. Models were estimated before and after controlling for key covariates.
  
  
  RESULTS
  About 21% of respondents reported lifetime NMUPD. After covariate adjustment, students who had reported any NMUPD were between 1.7 and 2.3 times more likely to report suicidal ideation, but not a suicide attempt (p < .0001). When stratified by sex and drug, nonmedical use of pain relievers, stimulants, and depressants were significantly associated with greater odds of suicidal ideation and behavior for both males and females (p < .05). However, NMUPD of pain relievers were not associated with greater odds of suicide attempts for males or females or among males who reported nonmedical use of stimulants. Nonmedical use of depressants was associated with greater odds of suicide attempts for both males and females (OR = 1.61 and 2.25, respectively) and among females who reported nonmedical use of stimulants (OR = 2.06, p < .01).
  
  
  CONCLUSIONS
  Results suggest that some adolescents may be inappropriately self-medicating psychological distress with prescription medications or NMUPD may promote suicide risk, especially for males and females who use depressants and females who use stimulants.
authors.affiliation: a Department of Social and Behavioral Sciences , West Virginia University School of Public Health , Morgantown , West Virginia , USA.
authors.forename: Keith J
authors.initials: KJ
authors.lastname: Zullig
authors.affiliation: b Department of Health Sciences , Western Illinois University , Macomb , Illinois , USA.
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Divin
authors.affiliation: c Department of Global and Community Health , George Mason University , Fairfax , Virginia , USA.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Weiler
authors.affiliation: d Purdue Pharma L.P. , Stamford , Connecticut , USA.
authors.forename: J David
authors.initials: JD
authors.lastname: Haddox
authors.affiliation: e Hassett Willis , Washington , DC , USA.
authors.forename: Lisa N
authors.initials: LN
authors.lastname: Pealer
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000700:Analgesics; D002492:Central Nervous System Depressants; D000697:Central Nervous System Stimulants; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D063487:Prescription Drug Misuse / Q000706:statistics & numerical data*; D012307:Risk Factors; D012651:Self Medication; D012737:Sex Factors; D013334:Students; D059020:Suicidal Ideation; D013405:Suicide / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology
chemical_list: D000700:Analgesics; D002492:Central Nervous System Depressants; D000697:Central Nervous System Stimulants
keywords: adolescents; nonmedical; prescription drugs; suicide