Suicide ideation and psychotropic recreational drug use by adolescents: a systematic review and meta-analysis

Sao Paulo Med J. 2024 Apr 22;142(4):e2022641. doi: 10.1590/1516-3180.2022.0641.R2.23012024. eCollection 2024.

Abstract

Background: Adolescence is characterized by complex and dynamic changes, often involving experimentation, including the use of psychotropic substances. Although it is well-established that recreational psychotropic drugs are associated with suicide ideation in adults, evidence of this association in adolescents remains limited.

Objective: To investigate the relationship between suicide ideation and psychotropic recreational drug use among adolescents.

Design and setting: Systematic review with meta-analysis developed at Universidade Federal de Uberlândia (UFU) and Universidade Estadual de Campinas (UNICAMP), Brazil.

Methods: A search across eight electronic databases for observational studies, without language or publication year restrictions, was conducted. The Joanna Briggs Institute tool was used to assess the risk of bias. Random-effects meta-analyses and odds ratios were used to measure the effects.

Results: The search yielded 19,732 studies, of which 78 were included in the qualitative synthesis and 32 in the meta-analysis. The findings indicated that suicidal ideation was 1.96 times more likely (95% confidence interval, CI = 1.47; 2.61) for adolescents who used some drug recurrently and 3.32 times more likely (95%CI = 1.86; 5.93) among those who abused drugs. Additionally, adolescents who used cannabis were 1.57 times more likely (95%CI = 1.34; 1.84) to experience suicide ideation compared with non-users, while cocaine users had 2.57 times higher odds (95%CI = 1.47; 4.50).

Conclusions: Psychotropic recreational drug use is associated with suicidal ideation among adolescents regardless of current or previous use, abuse, or type of substance used.

Systematic review registration: Registered in the PROSPERO database under the identification number CRD42021232360. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021232360.

Publication types

  • Systematic Review
  • Meta-Analysis

MeSH terms

  • Adolescent
  • Brazil / epidemiology
  • Female
  • Humans
  • Illicit Drugs
  • Male
  • Psychotropic Drugs*
  • Recreational Drug Use* / psychology
  • Recreational Drug Use* / statistics & numerical data
  • Risk Factors
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / psychology
  • Suicidal Ideation*

Substances

  • Psychotropic Drugs
  • Illicit Drugs