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Prevalence of non-medical use of prescription drugs and its associations with self-harm behaviors among Chinese college students
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DOI：10.1186/s12889-026-28591-8.png)
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Abstract
En 中文
Self-harm is a serious public health issue among young adults, closely linked to suicide risk. Non-medical use of prescription drugs (NMUPD) is increasingly prevalent in this population. However, there is a lack of comprehensive data on the prevalence and detailed patterns of NMUPD, self-harm and its association among Chinese college students. Using data from the 2019 Chinese College Students Health Survey, a nationally representative sample of 30,091 students was analyzed. Self-harm behaviors were classified as non-suicidal self-harm (NSSH) or suicidal self-harm (SSH). NMUPD was assessed across three categories: opioids, sedatives, and stimulants. Weighted multinomial logistic regression models examined associations between NMUPD and self-harm, adjusting for demographic, socioeconomic, and psychological factors. Subgroup analyses were conducted by college type and sex. The weighted prevalence of NMUPD was 6.1%, and the prevalence of NSSH and SSH were 2.3% and 2.1%, respectively. Among NMUPD users, NSSH prevalence was highest for any prescription drug use (APDU) (10.5%), while SSH prevalence was highest for APDU (19.3%) and opioids (14.2%). Fully adjusted models showed significant associations between NMUPD and SSH (opioids: AOR = 2.32, 95%CI: 1.74–3.10; sedatives: AOR = 3.41, 95%CI: 2.49–4.66; stimulants: AOR = 6.85, 95%CI: 3.41–13.75). Weaker associations were observed for NSSH, with opioids (AOR = 1.39, 95%CI: 1.03–1.86) and sedatives (AOR = 1.66, 95%CI: 1.15–2.38) remaining significant. Stratified analyses showed NMUPD was significantly associated with SSH in both sexes, while NSSH associations were significant only in males. In vocational colleges, NMUPD was associated to SSH, but sedative and stimulant use showed no association with NSSH. This study provides the first large-scale evidence of the association between NMUPD and self-harm among Chinese college students, emphasizing a stronger association with SSH. Findings highlight the need for targeted interventions, particularly among vocational college students and males, to mitigate suicide risk.
Keywords:
Opioids
Sedatives
Stimulants
Non-suicidal self-harm
Suicidal ideation
Suicidal attempt
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