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Suicidal ideation and attempts following nonmedical use of prescription opioids and related disorder

Published online by Cambridge University Press:  08 July 2020

Julian Santaella-Tenorio Open the ORCID record for Julian Santaella-Tenorio [Opens in a new window] ,
Silvia S. Martins ,
Magdalena Cerdá ,
Mark Olfson  and
Katherine M. Keyes
Julian Santaella-Tenorio*
Affiliation:
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
Silvia S. Martins
Affiliation:
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
Magdalena Cerdá
Affiliation:
Center for Opioid Epidemiology and Policy, NYU Grossman School of Medicine, NYU, New York, NY
Mark Olfson
Affiliation:
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, USA New York State Psychiatric Institute, New York, New York, USA
Katherine M. Keyes
Affiliation:
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Santiago, Chile
*
Author for correspondence: Julian Santaella-Tenorio, E-mail: js4222@columbia.edu
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Abstract

Background

Since 1999, the rate of fatal prescription opioid overdoses and of suicides has dramatically increased in the USA. These increases, which have occurred among similar demographic groups, have led to the hypothesis that the opioid epidemic contributed to increases in suicidal behavior, though the underlying association remains poorly defined. We examine the association between nonmedical use of prescription opioids/opioid use disorder and suicidal ideation/attempts.

Methods

We used longitudinal data from a national representative sample of the US adult population, the National Epidemiologic Survey on Alcohol and Related Conditions. Participants (n = 34 653) were interviewed in 2001–2002 (wave 1) and re-interviewed approximately 3 years later (wave 2). A propensity score analysis estimated the association between exposure to prescription opioids at wave 1 and prevalent/incident suicidal behavior at wave 2.

Results

Heavy/frequent (⩾2–3 times a month) prescription opioid use was associated with prevalent suicide attempts [adjusted risk ratio (ARR) = 2.75, 95% CI 1.35–5.60]. Prescription opioid use disorder was associated with prevalent (ARR = 1.98, 95% CI 1.20–3.28) and incident suicidal ideation (ARR = 2.59, 95% CI 1.25–5.37), and prevalent attempts (ARR = 4.19, 95% CI 1.71–10.27). None of the exposures was associated with incident suicide attempts.

Conclusions

Heavy/frequent opioid use and related disorder were associated with prevalent suicide attempts; opioid use disorder was also associated with the incident and prevalent suicidal ideation. Given population increases in nonmedical use of prescription opioids and disorder, the opioid crisis may have contributed to population increases in suicidal ideation.

Keywords

Attempted suicidedependenceopioid abuseopioid-related disordersuicidal ideation
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 2 , January 2022 , pp. 372 - 378
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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