Is there a correlation between opioid addiction and suicide?
It appears there is. In fact, this correlation is stronger than many realize – including medical medical professionals.
An article from the New England Journal of Medicine (NEJM) recently addressed this topic:
In 2016, the Centers for Disease Control and Prevention (CDC) reported 42,000 opioid-overdose fatalities, including an unknown number of suicides. Notably, two populations that are more likely than others to receive opioid prescriptions — patients with chronic pain and those with mood disorders — are also at greater risk for suicide.
Why is this the case?
First, it’s important to look at the statistics. The Centers for Disease Control and Prevention (CDC) reported that in 2016, there were 42,000 reported opioid overdose deaths. However, it becomes difficult to determine whether these deaths result by accidental overdose or an intentional suicide attempt. Thus, the number of suicides actually occurring through the use of opiate abuse is likely greater than is estimated.
Many times, a death from a suicidal overdose is listed as ‘unclassified’ as there is no concrete proof (such as a suicide note or talk of suicide).
Abuse takes place from those who start out as patients dealing with a health issue (such as a back injury, for example), who abuse their medications and become addicted. It also comes from those with primary opioid use disorder (OUD). Once this difference is determined, it leads to creating the best method of intervention.
Simply put, an intervention toward someone dealing with chronic pain and abuse is much different than intervention toward with OUD.
Those dealing with OUD are often so affected by their addiction, it can be difficult to differentiate between risky behaviors and a determined desire to consider suicide. So getting an accurate assessment can be difficult. Among the nearly 45,000 estimated suicides in the United States in 2016, around 15 percent took place by drug overdose. But getting a true handle on that is very difficult, as various factors prevent first responders and coroners from being able to specify a cause of death with complete certainty.
Tracking nationwide emergency room statistics
The NEJM study also takes a close look at data regarding emergency room visits nationwide. Looking at a large sampling of data – more than a quarter million emergency room cases – it shows that opiate overdose visits has been steadily increasing. In fact, their determination concluded that 54 percent of the overdoses encountered by emergency room personnel were unintentional. That leaves much to be examined closely from the other 46 percent of the overdoses. More than one-fourth of all overdoses were determined to be intentional, leaving around 20 percent as ‘undetermined.’
As trained medical professionals who often have the opportunity to learn a patient’s full history – either from the patient or from those who visit the patient in the hospital – these nurses and doctors are able to get a better assessment of a patient’s intentions and overall life situation.
As a result, the number of actual suicide attempts – and, applying similar data to actual suicides – the true and accurate number of suicides resulting from overdose could be much higher.
Importance of understanding suicide rates
By getting a better understanding of the scope of suicidal opiate users, it underscores the need to have a framework in place to make it possible for interventions to take place. Ideally, having a method for emergency personnel to not only spot but to have a method for dealing with opiate-related suicide attempts (namely, referral to trained professionals or even group discussion) would be very helpful to prevent further attempts and to have an accurate gauge on how to spot those at risk of suicide.
Public awareness is key to identifying opiate abusers who are at risk of suicide, and reaching those people with a specific tone before it is too late. Educational campaigns designed to bring this issue into a public forum will make it easier for families and friends to intervene. It will also create another avenue where those dealing with opioid addiction can not only limit or prevent suicidal ideations, but will also get them to speak about their addiction.
Of course, if you or anyone you know has suicidal thoughts or ideations, we recommend contacting any suicide hotline, including the National Suicide Prevention Lifeline at (800) 273-TALK (8255) or text TALK to 741741.