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Adults who misuse opioids have increased risk for suicide

Keith T. Chan

Individuals who reported using nonmedical prescription opioids in the last year were at higher risk for suicide than nonusers, according to recently published data.

Researchers found that although adults 18 to 24 experienced the highest rate of suicidality and nonmedical prescription opioid use, adults 50 years and older who reported nonmedical prescription opioid use were significantly more likely to experience suicidal thoughts.

“In addition to more comprehensive screenings for prescription opioid misuse, primary care physicians can help to address the prevalence of suicidality in older adults by encouraging those who are at risk to engage in mental health services,” Keith T. Chan, MSW, PhD, assistant professor for the School of Social Welfare at the University of Albany, SUNY, told Healio Primary Care Today. “For many older adults, primary care physicians may be their only point of contact in the medical system.”

Researchers used data from the 2016 National Survey on Drug Use Public Use File, which was designed to increase the level of honest reporting about substance abuse and mental health by allowing participants to answer privately and confidentially. Researchers used responses from the survey to evaluate suicidality and nonmedical prescription opioid use.

Suicidality was measured by researchers using three variables: serious thoughts of suicide, making suicidal plans, and suicide attempts in the last year. Researchers considered any self-reported use of prescription pain relievers not directed by a doctor as nonprescription opioid use. Sociodemographic variables such as age, race/ethnicity and gender were also evaluated, along with other reported substance use and health and mental health variables.

The study included 38,136 adults aged 18 years and older. Among the sample, 4.3% reported nonmedical prescription opioid use in the past year. Compared with nonusers, those who reported nonmedical prescription opioid use in the last year were 71% more likely to experience suicidal thoughts (OR = 1.71; 95% CI, 1.36-2.14), 95% more likely to have a plan to take their own life (OR = 1.95; 95% CI, 1.33-2.84), and were twice as likely to attempt suicide (OR = 2.25; 95% CI, 1.27-4).

While suicidality was more prevalent in adults 18 to 25 years old, the adjusted odds varied in different age groups. Compared with nonusers, adults 18 to 25 years old who reported nonmedical prescription opioid use were more likely to make a plan for suicide (OR = 2.62; 95% CI, 1.7-4.03). Users 50 years and older had the highest odds of experiencing serious suicidal thoughts compared to non-users (OR = 2.73; 95% CI, 1.17-6.39).

“The opioid epidemic is a national crisis, and there is a dire need for inter-professional collaborations,” Chan said. “Primary care physicians can play a central role in connecting older adults to much needed recovery efforts and interventions, through support from helping disciplines such as social work, nursing, psychology, and others who specialize in geriatric health and mental health services.” – by Erin Michael

Disclosures: The authors report no relevant financial disclosures.