Elevated rate of suicide risk in individuals with opioid use disorder

TL;DR

This study finds that individuals with opioid use disorder have a high and stable suicide risk over a year, with a history of intentional overdose being a key risk factor.

Contribution

This is the first study to evaluate suicide risk in opioid use disorder using multiple screening tools and to link intentional opioid overdose history to suicide risk.

Findings

Suicide risk screening rates remained stable over 12 months in individuals with opioid use disorder.

A history of intentional opioid overdose was significantly associated with suicide risk screening positive results.

Different screening tools detected varying rates of suicide risk in the same population.

Abstract

Few studies have longitudinally investigated suicide risk (SR) in opioid use disorder (OUD). This investigation administered three screening tools to individuals with OUD to compare rates of and variables associated with SR over 12 months.

121 individuals meeting criteria for OUD within the past 3 years were administered Item #9 of Patient Health Questionnaire‐9 (PHQ‐Item‐9), the twelfth item of DSM‐5‐TR Self‐Rated Level 1 Cross‐Cutting Measure (CCSM‐Item‐12), and the Ask Suicide‐Screening Questions (ASQ) to detect SR at Day 0 and Months 6 and 12. A partitioned generalized methods of moment (GMM) model identified variables associated with SR.

At Day 0, screen‐positive rates for SR were 30% for ASQ, 12.4% for PHQ‐Item‐9, and 4.1% for CCSM‐Item‐12. Rates were similar at Months 6 and 12. Variables significantly associated with SR by PHQ‐Item‐9 were intentional overdose history (p < .001), poor sleep (p < .001), meeting criteria for psychosis (p < .001), and meeting criteria for mania (p = .005). Variables significantly associated with SR by ASQ were intentional overdose history (p < .001), female gender (p = .003), meeting criteria for psychosis (p = .001), and total PHQ‐9 score (p = .032). Too few participants endorsed SR by CCSM‐Item‐12 to be included.

In the OUD population, screening positive for SR was unchanged over 1 year, but detection rates varied by screening tool. History of intentional opioid overdose is independently associated with screening positive for SR.

This is the first study to evaluate SR in the OUD population using more than one screening tool, and to show an association of history of intentional opioid overdose with SR.

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