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

Sampasa‐Kanyinga, Hugues; Bakwa-Kanyinga, Felly; Chaput, Jean‐Philippe; Hamilton, Hayley; Elton‐Marshall, Tara; Colman, Ian

doi:10.1007/s00127-020-01958-x

Cited by 10 publications

(2 citation statements)

References 29 publications

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“…Individuals with a history of self-harm and suicide may be more vulnerable to long-term opioid use as they seek relief from emotional distress through opioids. 42 At the same time, a heightened risk of suicide is strongly associated with the consumption of higher doses of prescribed opioids in pain management. 43 Notably, chronic widespread pain, the cardinal symptom RMD Open RMD Open RMD Open of fibromyalgia, is recognised as a potential contributor to the risk of suicidal thoughts or behaviours by clinical guidelines.…”

Section: Discussionmentioning

confidence: 99%

Machine learning identifies risk factors associated with long-term opioid use in fibromyalgia patients newly initiated on an opioid

Ramírez Medina,

Feng,

Huang

et al. 2024

RMD Open

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ObjectivesFibromyalgia is frequently treated with opioids due to limited therapeutic options. Long-term opioid use is associated with several adverse outcomes. Identifying factors associated with long-term opioid use is the first step in developing targeted interventions. The aim of this study was to evaluate risk factors in fibromyalgia patients newly initiated on opioids using machine learning.MethodsA retrospective cohort study was conducted using a nationally representative primary care dataset from the UK, from the Clinical Research Practice Datalink. Fibromyalgia patients without prior cancer who were new opioid users were included. Logistic regression, a random forest model and Boruta feature selection were used to identify risk factors related to long-term opioid use. Adjusted ORs (aORs) and feature importance scores were calculated to gauge the strength of these associations.ResultsIn this study, 28 552 fibromyalgia patients initiating opioids were identified of which 7369 patients (26%) had long-term opioid use. High initial opioid dose (aOR: 31.96, mean decrease accuracy (MDA) 135), history of self-harm (aOR: 2.01, MDA 44), obesity (aOR: 2.43, MDA 36), high deprivation (aOR: 2.00, MDA 31) and substance use disorder (aOR: 2.08, MDA 25) were the factors most strongly associated with long-term use.ConclusionsHigh dose of initial opioid prescription, a history of self-harm, obesity, high deprivation, substance use disorder and age were associated with long-term opioid use. This study underscores the importance of recognising these individual risk factors in fibromyalgia patients to better navigate the complexities of opioid use and facilitate patient-centred care.

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Section: Discussionmentioning

confidence: 99%

Machine learning identifies risk factors associated with long-term opioid use in fibromyalgia patients newly initiated on an opioid

Ramírez Medina,

Feng,

Huang

et al. 2024

RMD Open

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“…Clinical epidemiological studies have found high rates of comorbidity between these two behavioral traits, [18][19][20] especially withdrawal from or forced tapering states. 21 As a reflection of their interconnected relationship, risk of suicidal ideation and behaviour has been found markedly increased in people with OUD, with highest risk for more severe outcomes.…”

Section: Introductionmentioning

confidence: 99%

Cross-phenotype relationship between opioid use disorder and suicide attempts: new evidence from polygenic association and Mendelian randomization analyses

Huang

Chen

Levin

et al. 2022

Preprint

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IMPORTANCE: Clinical epidemiological studies have found high rates of comorbidity between suicide attempts (SA) and opioid use disorder (OUD). However, the patterns of correlation and causation between them are still not clear due to psychiatric confounding. OBJECTIVE: To investigate the pairwise associations and interrogate the potential bidirectional relationship between OUD and SA using genetically based methods. DESIGN, SETTING, AND PARTICIPANTS: We utilized raw phenotypes and genotypes from UK Biobank, and summary statistics from Million Veteran Program, Psychiatric Genomic Consortium, iPSYCH, and International Suicide Genetics Consortium. Statistical genetics tools were used to perform epidemiological association, genetic correlation, polygenic risk score prediction, and Mendelian randomizations (MR). Analyses were conducted to examine the OUD-SA relationship with and without controlling for psychiatric disease status (e.g., major depressive disorder [MDD]). MAIN OUTCOMES AND MEASURES: OUD and SA with or without major psychiatric disorders (schizophrenia, bipolar disorder, major depressive disorder, and alcohol use disorder). RESULTS: Strong correlations between OUD and SA were observed at both phenotypic level (overall samples [OR=2.94, P =1.59e-14]; non-psychiatric subgroup [OR=2.15, P =1.07e-3]) and genetic level (r2=0.4 and 0.5 with or without conditioning on MDD). The higher genetic susceptibility to SA can increase the polygenic risk of OUD (OR=1.08, false discovery rate [FDR] =1.71e-3), while the higher susceptibility to OUD can also increase the risk of SA (OR=1.09, FDR =1.73e-6). However, predictive abilities for both were much weakened after controlling for influence of psychiatric diseases. A combination of different MR analyses suggested a possible causal association from SA to OUD (2-sample univariable MR: OR=1.14, P = 0.001; multivariable MR: OR=1.08, P = 0.001). CONCLUSIONS AND RELEVANCE: This study provided new genetic evidence underlying the strong OUD-SA comorbidity. While controlling for the influence of psychiatric diseases, there is still some clue on possible causal association between SA genetic liability and the risk for OUD. Future prevention strategy for each phenotype needs to take into consideration of screening for the other one.

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Misuse of Prescription Opioids and Suicidal Behaviors Among Black Adolescents: Findings from the 2017 and 2019 Youth Risk Behavior Survey

Baiden

Eugene

Nicholas

et al. 2022

J. Racial and Ethnic Health Disparities

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

Cited by 10 publications

References 29 publications

Machine learning identifies risk factors associated with long-term opioid use in fibromyalgia patients newly initiated on an opioid

Machine learning identifies risk factors associated with long-term opioid use in fibromyalgia patients newly initiated on an opioid

Cross-phenotype relationship between opioid use disorder and suicide attempts: new evidence from polygenic association and Mendelian randomization analyses

Misuse of Prescription Opioids and Suicidal Behaviors Among Black Adolescents: Findings from the 2017 and 2019 Youth Risk Behavior Survey

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