Polydrug use as a risk factor for attempted suicide among secondary school students in a nationally representative sample in Puerto Rico

Suicide is a tragic and potentially preventable public health problem. Suicide attempts are more common than completed suicide; as many as 150 youths attempt suicide for every completed suicide in the United States. The objective of this study was to determine the association between suicidal attempts and polydrug use in a nationally representative sample of secondary school students in Puerto Rico. Consulta Juvenil has been designed as a monitoring program of the prevalence of substance use and violence and the risk factors associated with these problem behaviors in the student population. The survey was conducted during the 2005-07 academic year. The study utilizes a self-administered questionnaire that was translated and adapted from the “Student Survey of Risk and Protective Factors and Prevalence of Alcohol, Tobacco & Other Drug Use” of Catalano and Hawkins. Participants included 7,028 (52.4%) females and 6,389 (47.6%) males. From a total of 13,672 students, 18.1% were classified as polydrug users. The overall suicide attempt prevalence was 12%. Multiple logistic regression analysis revealed that females (OR=2.7, p<0.001), those who reported depression symptoms (OR=4.2, p<0.001) and those who were suspended from the school during the last year (OR=1.7, p<0.001) were more likely to be suicidal attempters. Polydrug use was the most important factor associated with suicidal attempt (OR=8.7, p<0.001). This study shows a positive association between polydrug use and suicidal attempts among Puerto Rican adolescents, suggesting that Hispanic youth who use multiple substances may be at higher risk for a suicidal attempt independently of their depression condition.