A trend analysis of the prevalence of opioid misuse, social support, and suicide attempt among American Indian/Alaska native high school students in New Mexico: 2009–2019 Youth Risk Resiliency Survey (YRRS)

Abstract

Background American Indian and Alaska Native (AI/AN) youth face stark inequities in opioid misuse, social support, and suicide attempt. This study examined trends in these behavioral measures among AI/AN students in New Mexico (NM). Methods Using the NM oversampled Youth Resiliency and Risk Survey (NM-YRRS, 2009 – 2019: odd years), prevalence estimates of opioid misuse, social support (SS), and suicide attempt for AI/AN high school students were generated. Trends over time were assessed via linear regression of weighted proportions according to Peter Armitage. Stratified trends by demographics were also employed. Results While the prevalence of suicide attempt did not change significantly over time, it was consistently higher among females (2011–2019), those who misused opioids, received low social support, had a mother with less than high school education, had a C, D, or F for academic performance, and non-straight students relative to their counterparts. In particular, the prevalence of suicide attempt among AI/AN students who reported opioid misuse in 2009 was significantly higher by 25.4% than their counterparts who did not report opioid misuse (35.8% vs. 10.4%.) A significant decreasing trend over time (2009–2017) was observed for opioid misuse (16.1%↓8.8%, p-value = 0.0033), including when stratifying by sex (males: 15.9%↓9%, p-value = 0.002; females: 16.2%↓8.6%, p-value = 0.012). Youth with high maternal education exhibited significant decline in opioid misuse (13.5%↓6.7%, p-value = 0.019; 2011–2017.) Opioid misuse increased significantly from 2017 to 2019 (8.8%↑12.9%, p-value < 0.0001.) For instance, in 2019 among AI/AN students who reported low social support, opioid misuse was roughly doubled (18.9% vs. 8.5%, p < 0.0001), and suicide attempt was tripled (21.3% vs. 7.0%, p < 0.0001) compared to students with high social support. Conclusion No significant trend was observed for suicide attempt. We observed a significant decreasing trend in opioid misuse between 2009 through 2017 but a significant increase from 2017 to 2019. A higher level of maternal education (college or above), and an A or B school grade performance were protective against both opioid misuse and suicide attempt.

Association between Non-Medical Use of Prescription Drugs and Emotional and Behavioral Problems among Chinese Adolescents: The Mediating Effects of Social Support

“…Second, Hameed et al (2018) found an adverse link between social support and EBPs among adolescents [53]. Agyemang et al (2022) found youth with low social support had the highest prevalence of suicide attempt [54]. Conversely, high social support contributed to increasing resilience and thus protecting adolescents from EBPs in Chinese adolescents [55,56].…”

Suicidal ideation, suicide attempt, and self‐injury among American Indian, Alaskan Native, and Native Hawaiian college students in the United States from 2015 to 2019

“…These models highlight key issues such as emotional dysregulation, interpersonal conflicts, trauma exposure, and the protective roles of social support and cultural connectedness. Additional empirical literature supports the emphasis of these models on social support and cultural connectedness as protective factors against suicide among Native youth 12–17 . Other important factors to investigate among American Indian, Alaska Native, and Native Hawaiian (AI/AN/NH) college students include gender and sexual minority status, mental illnesses/disorders, eating disorders, sleeping disorders, and other substance use disorders, which are associated with suicide risk in other studies 18–25 .…”

“…Additional empirical literature supports the emphasis of these models on social support and cultural connectedness as protective factors against suicide among Native youth. 12 , 13 , 14 , 15 , 16 , 17 Other important factors to investigate among American Indian, Alaska Native, and Native Hawaiian (AI/AN/NH) college students include gender and sexual minority status, mental illnesses/disorders, eating disorders, sleeping disorders, and other substance use disorders, which are associated with suicide risk in other studies. 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 Among AI/AN/NH college students, 22.1% report suicidal ideation, 11.8% attempt suicide, and 19.6% report self‐injury.…”

Opioid use, prescribing and fatal overdose patterns among racial/ethnic minorities in the United States: A scoping review and conceptual risk environment model

“…Acculturative stress is a particularly potent risk factor for opioid use among youth, and first, second and '1.5' generation immigrant youth in particular [114][115][116][117][118][119], given the higher levels of social/emotional malleability and lower levels of resilience that characterise this age group. To this end, racial/ethnic minorities tend to have lower rates of help-seeking and treatment for mental illness in comparison to Whites [120,121], in part due to intracultural stigma and insurance/geographic barriers, which can motivate nonmedical use of opioids as a coping mechanism.…”