The Relationship Between Past 12-month Suicidality and Reasons for Prescription Opioid Misuse

Overview

Journal J Affect Disord

Date 2019 Feb 13

PMID 30753953

Citations 10

Authors

Lisham Ashrafioun

Sarah Heavey

Taraneh Canarapen

Todd M Bishop

Wilfred R Pigeon

Affiliations

Soon will be listed here.

Abstract

Background: Understanding reasons for prescription opioid misuse can help elucidate suicide prevention efforts. The goal of the current study is to assess associations of reasons for prescription opioid misuse subtypes and suicide-related variables. We also assessed whether prescription opioid misuse differentiates ideators from those who attempt suicide.

Methods: Using data from the 2015-2017 National Survey of Drug Use and Health (N = 45,074), prescription opioid misuse subtypes were grouped as follows: (a) Pain only, (b) Other reasons, and (c) Mixed reasons (i.e., pain and at least one other reason). Logistic regressions examined associations of misuse subtypes and past 12-month suicide-related variables (ideation, planning, attempts) relative to non-misusers. Logistic regression analyses were also conducted among the subset reporting ideation to assess whether prescription opioid misuse differentiated ideators with no attempt from ideators with an attempt.

Results: In adjusted models, the Pain only and the Other reasons subtypes were associated with ideation and planning, but not attempts. The Mixed reasons subtype had higher odds of suicide ideation and planning compared to those not misusing prescription opioids and the Pain only misuse subtype. The Mixed reasons subtype had higher odds of a suicide attempt only when compared to those not misusing prescription opioids. Prescription opioid misuse was also associated with suicide attempts among the subset of ideators.

Conclusions: Findings indicate that people misuse prescription opioids for various reasons, and misuse subtypes are associated with past 12-month suicidality. Addressing pain and other reasons for misuse together through use of evidence-based treatments may help mitigate suicide risk.

Citing Articles

Community Collaboration for Suicide and Overdose Prevention: Attitudes, Perceptions, and Practices of Community-Based Professionals and County Leadership in New York State.

Gallant K, Harris B Community Ment Health J. 2024; 60(5):859-868.

PMID: 38374308 DOI: 10.1007/s10597-024-01238-x.

An overview of the use of psychoactive substances among students at the University of Lille during the COVID-19 health crisis: Results of the PETRA study.

Carton L, Bastien A, Cherot N, Caron C, Deheul S, Cottencin O Dialogues Clin Neurosci. 2023; 25(1):101-111.

PMID: 37837439 PMC: 10578082. DOI: 10.1080/19585969.2023.2268063.

Large-Scale Social Media Analysis Reveals Emotions Associated with Nonmedical Prescription Drug Use.

Al-Garadi M, Yang Y, Guo Y, Kim S, Love J, Perrone J Health Data Sci. 2023; 2022.

PMID: 37621877 PMC: 10449547. DOI: 10.34133/2022/9851989.

The association of prescription opioid use with suicide attempts: An analysis of statewide medical claims data.

Luo C, Chen K, Doshi R, Rickles N, Chen Y, Schwartz H PLoS One. 2022; 17(6):e0269809.

PMID: 35771866 PMC: 9246186. DOI: 10.1371/journal.pone.0269809.

Health harms of non-medical prescription opioid use: A systematic review.

Werb D, Scheim A, Soipe A, Aeby S, Rammohan I, Fischer B Drug Alcohol Rev. 2022; 41(4):941-952.

PMID: 35437841 PMC: 9064965. DOI: 10.1111/dar.13441.

References

Borges G, Loera C . Alcohol and drug use in suicidal behaviour. Curr Opin Psychiatry. 2010; 23(3):195-204. DOI: 10.1097/YCO.0b013e3283386322. View

Ashrafioun L, Bishop T, Conner K, Pigeon W . Frequency of prescription opioid misuse and suicidal ideation, planning, and attempts. J Psychiatr Res. 2017; 92:1-7. DOI: 10.1016/j.jpsychires.2017.03.011. View

Elman I, Borsook D, Volkow N . Pain and suicidality: insights from reward and addiction neuroscience. Prog Neurobiol. 2013; 109:1-27. PMC: 4827340. DOI: 10.1016/j.pneurobio.2013.06.003. View

McCabe S, Cranford J, West B . Trends in prescription drug abuse and dependence, co-occurrence with other substance use disorders, and treatment utilization: results from two national surveys. Addict Behav. 2008; 33(10):1297-305. PMC: 3163593. DOI: 10.1016/j.addbeh.2008.06.005. View

Turecki G, Brent D . Suicide and suicidal behaviour. Lancet. 2015; 387(10024):1227-39. PMC: 5319859. DOI: 10.1016/S0140-6736(15)00234-2. View

Ilgen M, Bohnert A, Ganoczy D, Bair M, McCarthy J, Blow F . Opioid dose and risk of suicide. Pain. 2016; 157(5):1079-1084. PMC: 4939394. DOI: 10.1097/j.pain.0000000000000484. View

Scherrer J, Salas J, Copeland L, Stock E, Ahmedani B, Sullivan M . Prescription Opioid Duration, Dose, and Increased Risk of Depression in 3 Large Patient Populations. Ann Fam Med. 2016; 14(1):54-62. PMC: 4709156. DOI: 10.1370/afm.1885. View

Xiang Y, Zhao W, Xiang H, Smith G . ED visits for drug-related poisoning in the United States, 2007. Am J Emerg Med. 2011; 30(2):293-301. DOI: 10.1016/j.ajem.2010.11.031. View

Ilgen M, Zivin K, Austin K, Bohnert A, Czyz E, Valenstein M . Severe pain predicts greater likelihood of subsequent suicide. Suicide Life Threat Behav. 2011; 40(6):597-608. DOI: 10.1521/suli.2010.40.6.597. View

10.

Dowell D, Haegerich T, Chou R . CDC Guideline for Prescribing Opioids for Chronic Pain - United States, 2016. MMWR Recomm Rep. 2016; 65(1):1-49. DOI: 10.15585/mmwr.rr6501e1. View

11.

Fischer B, Lusted A, Roerecke M, Taylor B, Rehm J . The prevalence of mental health and pain symptoms in general population samples reporting nonmedical use of prescription opioids: a systematic review and meta-analysis. J Pain. 2012; 13(11):1029-44. DOI: 10.1016/j.jpain.2012.07.013. View

12.

McCabe S, West B, Boyd C . Medical use, medical misuse, and nonmedical use of prescription opioids: results from a longitudinal study. Pain. 2013; 154(5):708-713. PMC: 3622844. DOI: 10.1016/j.pain.2013.01.011. View

13.

Fink D, Hu R, Cerda M, Keyes K, Marshall B, Galea S . Patterns of major depression and nonmedical use of prescription opioids in the United States. Drug Alcohol Depend. 2015; 153:258-64. PMC: 4509797. DOI: 10.1016/j.drugalcdep.2015.05.010. View

14.

Chesin M, Interian A, Kline A, Benjamin-Phillips C, Latorre M, Stanley B . Reviewing Mindfulness-Based Interventions for Suicidal Behavior. Arch Suicide Res. 2016; 20(4):507-27. DOI: 10.1080/13811118.2016.1162244. View

15.

McCabe S, Cranford J . Motivational subtypes of nonmedical use of prescription medications: results from a national study. J Adolesc Health. 2012; 51(5):445-52. PMC: 3479410. DOI: 10.1016/j.jadohealth.2012.02.004. View

16.

Ilgen M, Roeder K, Webster L, Mowbray O, Perron B, Chermack S . Measuring pain medication expectancies in adults treated for substance use disorders. Drug Alcohol Depend. 2010; 115(1-2):51-6. PMC: 3051016. DOI: 10.1016/j.drugalcdep.2010.10.007. View

17.

Im J, Shachter R, Oliva E, Henderson P, Paik M, Trafton J . Association of Care Practices with Suicide Attempts in US Veterans Prescribed Opioid Medications for Chronic Pain Management. J Gen Intern Med. 2015; 30(7):979-91. PMC: 4471010. DOI: 10.1007/s11606-015-3220-y. View

18.

Demidenko M, Dobscha S, Morasco B, Meath T, Ilgen M, Lovejoy T . Suicidal ideation and suicidal self-directed violence following clinician-initiated prescription opioid discontinuation among long-term opioid users. Gen Hosp Psychiatry. 2017; 47:29-35. DOI: 10.1016/j.genhosppsych.2017.04.011. View

19.

Klonsky E, May A . Differentiating suicide attempters from suicide ideators: a critical frontier for suicidology research. Suicide Life Threat Behav. 2013; 44(1):1-5. DOI: 10.1111/sltb.12068. View

20.

Brennan Braden J, Edlund M, Sullivan M . Suicide Deaths With Opioid Poisoning in the United States: 1999-2014. Am J Public Health. 2017; 107(3):421-426. PMC: 5296683. DOI: 10.2105/AJPH.2016.303591. View