Infectious Disease

Study links ‘shocking’ rise in child suicide rates to opioid crisis

December 11, 2023

3 min read

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Key takeaways:

  • From 2011 to 2018, child suicide rates in the United States increased by 83%.
  • A study linked the increase to the reformulation of OxyContin in 2010.

A rise in child suicides in the United States may be connected to the nation’s opioid crisis, according to a study published in Demography.

Although most researchers discuss the opioid crisis in terms of overdose deaths, the broader effects are often overlooked, according to the study’s author.

“Children are obvious and often forgotten victims of the opioid crisis,” David Powell, PhD, a senior economist at the RAND Corporation, told Healio. “They are much less likely to be directly exposed to prescription or illicit opioids, but having a parent die of an overdose or struggle with caretaking responsibilities is a traumatic event with potentially lifelong consequences.”

Powell said he noticed a change in the trend for child suicides in national mortality records around 2011.

“The mental health crisis among children has gotten some attention, including the high rate of child suicides, but I hadn’t seen anyone show how unprecedented this recent growth was both in duration and in magnitude,” Powell said.

His initial analysis found that child suicide rates were decreasing for over 30 years before 2010, after which they increased by 83% in just 8 years. Powell, who previously examined how the reformulation of OxyContin in 2010 led to increased rates of child neglect, wondered if there was evidence that reformulation might also have also impacted the child suicide rate.

In the study, Powell wrote that the introduction of an “abuse-deterrent version” of the opioid that year “made it more difficult to misuse OxyContin, and as access to abusable prescription opioids decreased, many individuals switched to illicit drugs.”

“The reformulation of OxyContin caused people to shift to illicit opioids, like heroin and fentanyl, fueling expansion in illicit opioid markets,” Powell told Healio. “Prior to reformulation, the opioid crisis was driven mainly by prescription opioids. After reformulation, the crisis transitioned to illicit opioids with some really disastrous consequences.”

Powell found 48,063 deaths designated as suicides for the 10- to 17-year-old population in the U.S. from 1980 to 2020. According to his study, areas of the U.S. that had more exposure to reformulated OxyContin “experienced sharper growth in child suicide rates.”

“The evidence suggests that children’s illicit opioid use did not increase, implying that the illicit opioid crisis engendered higher suicide propensities by increasing suicidal risk factors for children, such as increasing rates of child neglect and altering household living arrangements,” he wrote.

“I found the overall trend in child suicide rates to be shocking,” Powell told Healio. “There’s been research documenting child suicide rates at different points in time, but I was surprised to see in the data that child suicide rates had been declining almost continuously from 1988 to 2010 before such an abrupt reversal.”

Suicide rates then increased every year from 2011 to 2018, resulting in an overall increase in child suicide rates of 83%. That increase in duration and magnitude was “striking,” according to Powell.

“The broader impacts of the opioid crisis are pervasive and affect us in countless dimensions, but I was surprised at the magnitudes of the effects on child suicides,” Powell said.

He said future studies should consider the potential mechanisms that create this relationship between the illicit opioid crisis and child suicide rates.

“It might be that the illicit opioid crisis has decreased children’s perception of safety in their neighborhood more broadly,” Powell said. “That’s also an important suicide risk factor for children. Identifying the relative importance of those types of mechanisms, especially when comparing very proximate causes vs. broader social mechanisms, would suggest different paths forward when thinking about how to best address this crisis.”

Powell added that the trends in child suicides merit much more attention on their own, with the 8-year increase from 2011 to 2018 being “unprecedented.”

“The paper makes this connection between the opioid crisis and child suicide crisis,” Powell said. “However, one contribution of the paper is simply documenting the recent rise in child suicides and placing it in an historical context. The high rate of child suicides is known, but I don’t think it receives nearly enough attention.”

References:

Powell D. Demography. 2023;doi:10.1215/00703370-11077660.

Increase in child suicide linked to the nation’s opioid crisis. https://www.eurekalert.org/news-releases/1010073. Published Dec. 4, 2023. Accessed Dec. 11, 2023.

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infectious diseases in children

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