Number of opioid overdoses and depression as a predictor of suicidal thoughts
Drug and Alcohol Dependence. 2021-07-01; 224: 108728
DOI: 10.1016/j.drugalcdep.2021.108728
Lire sur PubMed
Brown LA(1), Denis CM(2), Leon A(3), Blank MB(4), Douglas SD(5), Morales KH(6), Crits-Christoph PF(7), Metzger DS(8), Evans DL(9).
Author information:
(1)University of Pennsylvania, Department of Psychiatry, 3535 Market Street,
Philadelphia, PA, 19104, USA. Electronic address: .
(2)University of Pennsylvania, Department of Psychiatry, 3535 Market Street,
Philadelphia, PA, 19104, USA. Electronic address: .
(3)University of Pennsylvania, Department of Psychiatry, 3535 Market Street,
Philadelphia, PA, 19104, USA. Electronic address:
.
(4)University of Pennsylvania, Department of Psychiatry, 3535 Market Street,
Philadelphia, PA, 19104, USA. Electronic address: .
(5)Children’s Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia,
PA, 19104, USA; University of Pennsylvania, Department of Pediatrics, 3401 Civic
Center Blvd., Philadelphia, PA, 19104, USA. Electronic address:
.
(6)University of Pennsylvania, Department of Biostatistics, Epidemiology and
Informatics, 423 Guardian Dr, Philadelphia, PA, 19104, USA. Electronic address:
.
(7)University of Pennsylvania, Department of Psychiatry, 3535 Market Street,
Philadelphia, PA, 19104, USA. Electronic address: .
(8)University of Pennsylvania, Department of Psychiatry, 3535 Market Street,
Philadelphia, PA, 19104, USA. Electronic address: .
(9)University of Pennsylvania, Department of Psychiatry, 3535 Market Street,
Philadelphia, PA, 19104, USA.
BACKGROUND: Opioid use disorders are associated with increased risk of suicide
thoughts, attempts, and death. We explored key variables from two theories of the
development of suicidal thoughts and attempts (the interpersonal and three-step
theories of suicide) to understand possible mechanisms underlying the association
between opioid use and suicide risk. We hypothesized that interpersonal
connections, variables reflecting psychological and physical pain, and variables
that reduce fear of death (prior overdoses and risk-taking behaviors) would be
associated with increased risk of thoughts of suicide.
METHODS: Participants (N = 141) were opioid users recruited from an epicenter of
the opioid crisis in Philadelphia using a mobile research center and completed an
interview to assess substance use, depression, medical comorbidities, and
suicidal thoughts among other variables.
RESULTS: Univariate analyses showed that prior history of overdose, diagnosis of
depression, older age, homelessness, and interpersonal connection were each
associated with increased likelihood of endorsing thoughts of death/suicide.
Multivariable analyses revealed prior history of overdose and depression were the
variables most strongly associated with risk for thoughts of suicide.
CONCLUSIONS: Consistent with two theories of the development of suicidal thoughts
and attempts, exposure to variables that reduce fear of death (e.g., overdoses)
were associated with suicidal thoughts. In contrast, other risk-taking behaviors,
medical comorbidities, and substance use were not key predictors of suicidal
thoughts in this sample. Implications for targeted risk assessment among
clinicians are discussed.
Copyright © 2021 Elsevier B.V. All rights reserved.