What has drugs use and other factors got to do with suicidal behaviour among in-school students in Bolivia? Analysis of a national survey

Abstract

Background About 23.5% and 13.2% of female and male students respectively ever attempted suicide in 2017 in Bolivia. The annual prevalence of drugs usage such as marijuana has increased in Bolivia. Studies have highlighted that substance abuse correlates with suicidal behaviours. The association between drug use and suicidal behaviour is less explored in Bolivia. This study aimed at investigating the association between drug use and suicidal behaviour among in-school students in Bolivia. Methods The study relied on a dataset obtained from the 2018 Bolivian Global School-Based Student Health Survey (BGSHS). The survey followed a two-stage cluster sampling procedure and in all, a total of 7,931 in-school students were interviewed yielding a response rate of 79%. However, this study was restricted to 4,684 in-school students who have complete data about variables of interest analysed in the study. Suicidal behaviour and drug use were the outcome variable and main explanatory variables, respectively. At 95% confidence interval, two models were built using logistic regression. Model I assessed the association between the outcome variable and the main explanatory variable and Model II controlled the influence of covariates on suicidal behaviour. The results for Model II were presented in adjusted Odds Ratio (aOR). Results Generally, 17% (weighted N = 813; CI = 0.16–0.18) of students indulged in suicidal behaviour. Inferentially, those who ever used drugs were over two-fold likelihood to indulge in suicidal behaviour compared with those who were not on drugs in the unadjusted model [OR = 2.59, CI = 2.08–3.21] and this persisted in the adjusted model [aOR = 1.52, CI = 1.07–2.17]. Females [aOR = 3.02, CI = 2.51–3.63], those whoever had difficulties sleeping [aOR = 2.23, CI = 1.70–2.89], ever used alcohol [aOR = 1.57, CI = 1.30–1.90] and whose parents go through their things [aOR = 1.48, CI = 1.24–1.76] had higher odds of suicidal behaviour. The likelihood of suicidal behaviour reduced among those whose parents understand their problem [aOR = 0.55, CI = 0.45–0.68] and know their free time [aOR = 0.62, CI = 0.50–0.78] or were not bullied [aOR = 0.57, CI = 0.47–0.68]. Conclusion The study revealed that drugs use was associated with suicidal behaviour among in-school students in Bolivia. Other findings were that alcoholism, poor parental concern, bullying and having a history of physical attacks were associated with suicidal behaviour. The Government of Bolivia through its law enforcement agencies should strengthen their strategies targeted at controlling drug usage among in-school students. Parents should extend emotional support and care to in-school students so that their wards can properly cope and manage their emotional challenges appropriately.