The U.S. opioid crisis is taking a toll on children of users as a study published on Wednesday showed they were more likely to attempt suicide.

The study in JAMA Psychiatry published by the American Medical Association found children whose parents were prescribed opioids were twice as likely to attempt suicide as the offspring of people who did not use those drugs.

The latest study from researchers at the University of Chicago and the University of Pittsburgh is the first research attempting to tie rising suicides among U.S. children to the opioid crisis.

“I think that it’s obvious in many ways; it’s just that we were able to put it together and prove it,” said Dr. David Brent, one of the authors of the study.

Brent, of the University of Pittsburgh, said he believes some opioid users might display less care, monitoring and affection for their children, which would explain the higher suicide rate in those kids.

Suicide increased across all ages in the United States between 1999 and 2016, spiking by over 30% in half the country, the U.S. Centers for Disease Control and Prevention reported last year.

Another study found that among girls age 10 to 14 the suicide rate rose by 12.7% per year after 2007.

In the latest study, researchers used medical insurance data from 2010 to 2016 for more than 300,000 children ages 10 to 19, and broke that group down into those whose parents were prescribed opioid drugs and those whose parents were not.

Among the children of parents who used opioids, 0.37% attempted suicide, compared to 0.14 % of the children of non-users, according to the study, which was funded by the National Institutes of Health.

The parents were all legally prescribed opioids that they used for at least a year. The study did not identify which of those users may have been abusing painkillers, as opposed to using them in line with doctor recommendations.

Challenges for children of drug users

Children of opioid users still had a significantly higher risk of attempting suicide after researchers adjusted for factors such as depression and parental history of suicide.

Some researchers have suggested social media could harm children’s self esteem and increase their suicide risk.

But Brent and his co-authors noted social media is prevalent in countries that have not seen a rise in child suicide.

U.S. President Donald Trump declared the opioid crisis a public health emergency in October 2017 and has promised to hold drugmakers accountable for their part in the crisis.

Nearly 400,000 people died of overdoses between 1999 and 2017 in the United States, resulting in the lowering of overall life expectancy for the first in more than 60 years, according to data from the Centers for Disease Control and Prevention.

Eric Rice, an associate professor at the University of Southern California’s school of social work, said other research has found children of drug users face challenges.

“A doubling in the suicide rate is a pretty shocking manifestation of that, I’ve got to be honest,” Rice said. “But to hear that there are impacts on children which are negative is not a surprising thing,” said Rice, who was not involved with the study.

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