Increasing illicit opioid use among adults linked to increased suicide rates in youth

Rising youth suicide rates are partially tied to the opioid crisis that has disrupted home lives and caused trauma for children throughout the country, according to a recent study from the RAND Corporation.

“While the use of illicit opioids did not increase among children, it appears they were negatively affected by the broader effects of the illicit opioid crisis,” said David Powell, the study’s lead author and a senior economist at RAND. “The results are consistent with the growth in illicit opioid use among the adult population generating worsening conditions for children by increasing rates of child neglect.”

There was a 169 percent increase in deaths among youths ages 14-18 from 2019 to 2020, followed by a near 30 percent increase from 2020 to 2021, according to the Centers for Disease Control and Prevention. In 2021, almost one in three teenage girls reported seriously considering attempting suicide.

Background

Researchers looked at suicide rates from 1980 to 2020 of children ages 10-17 and noted an “unprecedented rise” from 2011 to 2018. In 2010, the opioid OxyContin was reformulated to make it harder to crush the pills to inject or snort the drug. This change caused people who misused opioids to seek other sources of drugs, leading to a large increase in the use of illicit opioids.

Following the reformulation, child suicide rates began rapidly increasing, researchers found. Geographic areas that had higher preexisting rates of prescription OxyContin misuse experienced sharper growth in child suicide rates.

The formula shift, while well-intentioned, likely led to a steep rise in the use of illicit opioids such as heroin and fentanyl, and may have contributed to the growth of illicit opioid markets.

While there was little evidence of changes in drug overdose rates for children aged 10 to 17 — suggesting little change in illicit opioid use among the group — the report cited worsening living conditions for youth including neglect, disrupted home lives, reduced household income and crime.

In assessing the link between child suicide and the opioid crisis by analyzing information from the National Vital Statistics System Multiple Cause of Death mortality and the National Survey on Drug Use and Health, researchers suggested that the reformulation of OxyContin can explain 49 percent of the rise in child suicides from 2011 to 2020. The effects of reformulation on child suicides disproportionately affected white children and Asian American and Pacific Islander children.

“This study provides evidence of the importance of a social change — the reformulation of OxyContin — as a potentially important factor contributing to the recent unexplained increase in child suicides,” Powell said. “The transition to illicit opioids has altered households and society in several documented ways and likely on countless unstudied dimensions.”

New California law

Throughout the country, schools have sought to support students suffering mental health crises by hiring more counselors and social workers and creating wellness centers that children can access on campus, as well as by partnering with community-based mental health providers.

In California, students will be required to learn about the dangers of opioids, including information about deadly synthetic pills containing fentanyl, under legislation signed last year by Gov. Gavin Newsom. Senate Bill 10 mandates that every public school serving students grades 7-12 include the development of a protocol in the event a pupil is suffering or is reasonably believed to be suffering from an opioid overdose under a formal plan known as a Comprehensive School Safety Plan, or CSSP. The bill also establishes a state framework to ensure all students understand the growing risk of fentanyl exposure and have access to the resources needed to prevent and respond to fentanyl poisoning and overdoses.