Suicide is a leading cause of death for teens worldwide, and the odds of suicide attempts may be higher when adolescents abuse prescription drugs, a Chinese study suggests.

To explore the connection between suicide risk and misuse of prescription opiates and sedatives, researchers surveyed about 3,300 Chinese teens once when they were about 14 years old and again a year later.

Teens who said they used prescription drugs for non-medical reasons at the start of the study were almost three times as likely to report a suicide attempt a year later, and the risk was more than tripled for youth who abused opiates, researchers report in JAMA Pediatrics.

"Baseline opioids misuse, sedatives misuse, and nonmedical use of . . . prescription drugs were positively associated with later suicidal ideation," said lead study author Dr. Lan Guo of Sun Yat-sen University in Guangzhou.

More on this...

Those thoughts were more likely to turn into suicide attempts with "baseline opioids misuse and nonmedical use of any prescription drugs," Guo added by email.

Less than 3 percent of the teens reported misuse of any prescription drugs, with 1.8 percent saying they used opiates or stimulants for nonmedical reasons and about 1 percent reporting abuse of sedatives.

Overall, 17 percent of the participants reported suicidal thoughts, and 3 percent reported suicide attempts in the survey at the end of the study.

The link between drug abuse and suicide persisted even after researchers accounted for teens who reported experiencing depression at the start of the study.

While the study doesn't examine why abuse of prescriptions and other drugs might be linked to a greater suicide risk, it's possible that these drugs might alter teens' moods or lower inhibitions in a way that allows suicidal impulses to flourish, the authors conclude.

Limitations of the study include its reliance on teens to accurately report and recall both drug use and suicidal thoughts or suicide attempts, the authors note.

It's not surprising, however, that the same teens who are prone to abusing drugs would also be susceptible to suicidal thoughts, said Dr. Bernard Biermann, an adolescent psychiatry researcher at the University of Michigan's C.S. Mott Children's Hospital in Ann Arbor.

"Substance abuse can be associated with causing depression and distress, but it's also a means of self-medicating," Biermann, who wasn't involved in the study, said in a phone interview.

It's essential that parents keep an eye on teens for changes in behavior that go beyond temporary moodiness to suggest a bigger problem, said Dr. Benjamin Shain, a researcher at the University of Chicago and head of child and adolescent psychiatry at NorthShore University HealthSystem.

"Growing up has always been difficult and life now is even more complicated," Shain, who wasn't involved in the study, said by email. "Parents should take seriously severe or persistent distress and changes in behavior, such as isolation or falling grades, and bring their teen to their primary care physician or a mental health professional with any signs."

Parents should also try to make it harder for teens to get their hands on things to harm themselves, said Dr. Yolanda Evans, an adolescent medicine specialist at Seattle Children's Hospital who wasn't involved in the study.

"When possible, avoid having things readily available that teens may impulsively use to end their life," Evans said by email. "Old narcotics or medications should be discarded (look for pharmacy take back options)."