Prevalence of non-medical use of prescription drugs and its associations with self-harm behaviors among Chinese college students
- 1Center for Big Data and Intelligent Medicine, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400016 China
- 2Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, No.74 Zhongshan Road 2, Guangzhou, 510080 China
- 3International Center for Reproductive Health (ICRH), Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, 9000 Belgium
Abstract
Background: 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.
Methods: 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.
Results: 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.
Conclusion: 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.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12889-026-28591-8.
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BibTeX
@article{shi2026prevalence,
title = {{Prevalence of non-medical use of prescription drugs and its associations with self-harm behaviors among Chinese college students}},
author = {Jingman Shi and Wenjian Lai and Guangduoji Shi and Yuwei Zhang and Yanzhi Li and Xiaojuan Zhang and Herui Wu and Yang Yang and Wenjing Zhou and Ciyong Lu and Wei-Hong Zhang},
journal = {BMC Public Health},
year = {2026},
month = aug,
doi = {10.1186/s12889-026-28591-8},
url = {https://doi.org/10.1186/s12889-026-28591-8},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Prevalence of non-medical use of prescription drugs and its associations with self-harm behaviors among Chinese college students
AU - Jingman Shi
AU - Wenjian Lai
AU - Guangduoji Shi
AU - Yuwei Zhang
AU - Yanzhi Li
AU - Xiaojuan Zhang
AU - Herui Wu
AU - Yang Yang
AU - Wenjing Zhou
AU - Ciyong Lu
AU - Wei-Hong Zhang
PY - 2026
DA - 2026/08/12
JO - BMC Public Health
DO - 10.1186/s12889-026-28591-8
UR - https://doi.org/10.1186/s12889-026-28591-8
AB - Background: 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. Methods: 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. Results: 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. Conclusion: 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. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12889-026-28591-8.
SN - 1471-2458
ER -