A study published in the American Journal of Psychiatry and conducted by Columbia University Mailman School of Public Health and Columbia University Irving Medical Center researchers highlighted a link between changes in regional opioid prescribing and regional suicide rates. The study revealed significant patterns between high-dose prescribing and long-term prescribing rates. In addition, a patient having multiple opioid prescribers is also a critical factor in suicide risk. The study suggests a possibility that individuals who abuse opioids are at greater risk for self-harm after tapering or ceasing opioid consumption.
The researchers examined opioid prescribing measures for four age groups: 10–24, 25–44, 45–64, and 65 years or older. Since the length of opioid prescribing is strongly associated with heavy opioid use, the researchers included a measure of percentage with opioid prescriptions for long-term opioid prescriptions measured at greater than or equal to 60 consecutive days.
Opioid prescribing declined during 2009–2017, and suicide death rates increased. The researchers estimated that had opioid prescribing remained constant rather than decreased, the national rate of suicide would have risen even faster than it did.
Data analysis of data from the 2009–2017 U.S. Longitudinal Prescription Database and National Center for Health Statistics mortality data. Information was based on opioid prescribing, with high-dose prescriptions (>120 mg/day morphine equivalents), with long-term prescriptions (>60 consecutive days), and with prescriptions from three or more prescribers. The researchers used states and commuting zones defined by the U.S. Department of Agriculture for geographic aggregation.
The study emphasizes the complex relationship between opioid prescribing and suicide risk. Study author Dr. Mark Olfson, MD, MPH and Dollard Professor of Psychiatry explained why this connection between the two phenomena: ”People can become desperate if their pain is not well controlled. Yet opioids also pose a greater risk of overdose than any other drug class and approximately 40 percent of overdose suicide deaths in the U.S. involve opioids.” The researchers also noted a positive association change in regional suicide deaths, regional opioid prescriptions, and a change in percentage with at least one opioid prescription among individuals in the 45- to 64-year age group. The association with change in suicide deaths was significantly higher in the West than in the East or the Midwest.
Health professionals advocate for more effective suicide prevention initiatives for people with opioid use disorder. Opioid prescription policies and practices should account for the possible connections between prescription opioids and suicide risk.
Sources: Eureka News Alert, Journal of American Psychiatry
