Prescription Opioid Misuse, Comorbid Substance Use, and Suicidal Behaviors Among US Young Adults: Findings from 2015-2019 National Survey on Drug Use and Health.

Background: Few studies to date have examined the number of comorbid substances used alongside Prescription Opioid Misuse (POM) to predict suicidal behaviors among US young adults.

Objective: This study investigated the relationship between comorbid substance use with POM and suicidal behaviors among the US young adults.

Methods: Data were from individuals aged 18-25 (N = 69,204, 51.8% female) in the 2015-2019 National Surveys on Drug Use and Health (NSDUH). The final analytic sample for logistic regression was 36,892 young adults.

Results: After controlling for key covariates, the combination of POM and three or more illicit drugs were at the greatest odds of suicidal ideation (OR = 2.57, 95% CI = 1.61 - 4.11, p < 0.001) and attempts (OR = 3.57, 95% CI = 1.89 - 6.76, p < 0.001) compared to those without POM or drug use.

Conclusions: The study provides evidence of a dose-response relationship between the number of illicit drugs uses alongside POM and the suicide risk as a clinically important phenomenon with implication for intervention. Findings highlight that POM, with or without illicit drug use, can serve as a behavioral and clinical indicator for identifying young adults at heightened risk of suicidality. This group warrants prioritized intervention targets to ensure timely access to developmentally appropriate clinical treatment, aiming to mitigate addiction progression and prevent harm and mortality.