Citation

Samples H, Stuart EA, Olfson M. Am. J. Epidemiol. 2019; 188(7): 1245-1253.

Affiliation

Department of Psychiatry, Columbia University Medical Center, New York, NY.

Copyright

(Copyright © 2019, Oxford University Press)

DOI

10.1093/aje/kwz061

PMID

30834448

Abstract

Prior research has shown associations between opioid misuse and suicidal behaviors, but the relationship between medical opioid use and suicidal behaviors is not known. We assessed associations between opioid use and misuse to suicidal ideation, suicide plans, and suicide attempts among adults 18-64 years old (n=86,186) using nationally representative cross-sectional data from the 2015-2016 National Survey on Drug Use and Health. We used logistic regression to estimate associations between opioid use/misuse and suicidal behaviors and propensity score weighted logistic regression to examine the counterfactual scenario in which individuals with misuse had instead not misused opioids. In propensity score weighted analyses compared to opioid misuse, use without misuse was associated with lower odds of ideation (odds ratio [OR]=0.57; 95% confidence interval [CI]: 0.45, 0.72) and plans (OR=0.53; 95% CI: 0.35, 0.80), and no use was associated with lower odds of ideation (OR=0.62; 95% CI: 0.49, 0.80), plans (OR=0.56; 95% CI: 0.39, 0.79), and attempts (OR=0.54; 95% CI: 0.33, 0.89). Opioid misuse is associated with greater odds of suicidal behaviors but use without misuse is not. Compared to individuals with opioid misuse, similar individuals without misuse have reduced risk of suicidal behaviors. Clinical and public health interventions should focus on preventing misuse.

© The Author(s) 2019. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Language: en

Keywords

attempted suicide; non-medical use of prescription drugs; opioid abuse; opioids; prescription drug misuse; suicidal ideation; suicide