Multiple substance use and self-reported suicide attempts by adolescents in 16 European countries

Abstract

Substance use and suicide attempts are high-risk behaviors in adolescents, with serious impacts on health and well-being. Although multiple substance use among young people has become a common phenomenon, studies of its association with suicide attempts are scarce. The present study examines the association between multiple substance use and self-reported suicide attempts in a large multinational sample of adolescent students in Europe. Data on multiple substance use (tobacco, alcohol, tranquillizers/sedatives, cannabis, other illegal drugs) and self-reported suicide attempts were drawn from the 2007 European School Survey Project on Alcohol and Other Drugs (ESPAD). The ESPAD survey follows a standardized methodology in all participating countries. The present study is based on 45,086 16-year-old adolescents from 16 countries that had used the optional "psychosocial module" of the questionnaire, thereby including the question on suicide attempts. Logistic regression analyses were performed to examine the associations of any self-reported suicide attempt (dependent variable) with substance use controlling for country and gender. The strongest association with self-reported suicide attempts was for any lifetime tranquillizer or sedative use (odds ratio 3.34, 95 % confidence interval 3.00-3.71) followed by any lifetime use of illegal drugs other than cannabis (2.41, 2.14-2.70), 30-day regular tobacco use (2.02, 1.84-2.21), 30-day frequent alcohol use (1.47, 1.32-1.63) and any 30-day cannabis use (1.37, 1.18-1.58). The odds ratio of reporting a suicide attempt approximately doubled for every additional substance used. These findings on the association between multiple substance use, including legal drugs (tranquillizers or sedatives and tobacco), and the life-threatening behavior of suicide attempts provide important cues for shaping prevention policies.

Suicide in Children and Adolescents

“…They concluded that the odds of suicide attempt approximately doubles for every additional substance used. [13] …”

“…[19] Substance Use A number of studies have shown that suicidal behavior has been highly associated with substance use in children and adolescents. [4][5][6]13,20,21] In youth, suicide tendency, suicidal ideation and suicide attempts are predicted best by early onset of alcohol consumption, marihuana use, tobacco use, other substance use and alcohol and/or substance. [21][22][23][24] Early initiation of problem behaviors such as alcohol drinking, cigarette smoking and sexual intercourse, particularly among preteens, predicted later suicidal ideation and suicide attempts in both sexes.…”

“…Suicide attempt in other words suicidal behavior is any action that could cause a person to die. In 2009, 13.8% of United States of America (USA) high school students reported that they had seriously considered attempting suicide during the 12 months preceding the survey. In the study, 6.3% of students reported that they had actually attempted suicide one or more times during the same period.…”

“…[12] Even worse in the 27 European Union countries, suicide is second leading cause of death among young people aged between 15-19 years old. [13] Every S year, almost one million people commit suicide worldwide which comprises approximately 1.5% of all deaths. Thus suicide is the tenth leading cause of death globally.…”

“…[10,13,15] Bereavement refers to the loss of a loved one by death and grief refers to the distress resulting from bereavement. Prigerson and colleagues reported that 6% of bereaved extended family members develop complicated grief (i.e.…”