Frequency of prescription opioid misuse and suicidal ideation, planning, and attempts

Ashrafioun, Lisham; Bishop, Todd M.; Conner, Kenneth R.; Pigeon, Wilfred R.

doi:10.1016/j.jpsychires.2017.03.011

Cited by 93 publications

(68 citation statements)

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“…African American males’ psychosocial risk combined with the high accessibility of opioids in urban communities (Draus et al, 2012) is concerning and has implications for increased risk of accidental overdose (CDC, 2017a), suicidality (Ashrafioun et al, 2017), contraction of HIV, Hepatitis C (CDC, 2017b; Spaulding et al, 2009), and significant public health costs (Birnbaum et al, 2011).…”

Section: 0 Discussionmentioning

confidence: 99%

“…The psychosocial context in which substance use exists has been linked to mental illness among criminal justice-involved African Americans (Calcaterra et al, 2014; Western et al, 2015). More specific to NMOU, cross-sectional studies (Davis et al, 2017), meta-analyses (Fischer et al, 2012), secondary analyses of population-based surveys (Ashrafioun et al, 2017), and longitudinal analysis (Martins et al, 2012) have revealed individuals who engage in NMOU are significantly more likely to have mental health problems. Others have posited NMOU is motivated by the desire to attenuate psychological distress (Martins et al, 2009; Martins et al, 2012).…”

Section: 0 Introductionmentioning

confidence: 99%

“…Though extant research illustrates a convincing relationship between mental health concerns and NMOU among community-based individuals, little is known about how this association potentially manifests among criminal justice-involved African Americans. Given the associated increased risk of suicide (Ashrafioun et al, 2017), accidental overdose (O’Donnell et al, 2017; Yarborough et al, 2016), future research with this subgroup is vital to promoting public health.…”

Section: 0 Introductionmentioning

confidence: 99%

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Trends and mental health correlates of nonmedical opioid use among criminal justice-involved African American men

Knighton

Stevens‐Watkins

Staton

et al. 2018

Addictive Behaviors

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Background The Centers for Disease Control and Prevention has deemed nonmedical opioid use (NMOU) an epidemic. Population-based survey data indicate high rates of NMOU among Caucasians, however, these estimates exclude incarcerated samples and may underestimate use among criminal justice-involved African Americans. Despite opioid-associated risks of co-occurring mental illness and mortality, to our knowledge, this is the first study to examine NMOU and mental health among a sample of African American men receiving corrections-based substance use disorder (SUD) treatment in jail, prison, or the community. Method We conducted a cross-sectional study examining trends and mental health correlates of NMOU during the year prior to each participant’s incarceration, across five cohorts of African American men (N = 4,021) enrolled in corrections-based SUD treatment between the years, 2010 and 2014. A series of chi-square, ANOVAs, correlations, and logistic regression models were conducted. Results Over 20% of our sample reported NMOU during the year prior to incarceration. On average, participants were 36-years-old, earned 13 years of education, and were generally unemployed, prior to incarceration. We found a statistically significant positive linear trend between NMOU prior to incarceration and cohort year. The final stepwise multivariate regression model was significant and revealed, older age was associated with lower odds of NMOU. More years of education and frequent mental health symptoms were associated with significantly increased odds of NMOU. Discussion Our findings are unique in that extant literature has primarily described NMOU as a ‘White suburban’ problem. Culturally-adapted behavioral interventions and medication assisted therapies are discussed.

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Section: 0 Discussionmentioning

confidence: 99%

Section: 0 Introductionmentioning

confidence: 99%

Section: 0 Introductionmentioning

confidence: 99%

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Trends and mental health correlates of nonmedical opioid use among criminal justice-involved African American men

Knighton

Stevens‐Watkins

Staton

et al. 2018

Addictive Behaviors

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“…In adolescents, both cross‐sectional and longitudinal evidence link opioid and benzodiazepine PDM with suicidal ideation. Work across the US adult population also supports a link between opioid PDM and suicidal ideation . While opioid‐related mortality rates rose among US older adults from 2006 to 2013, it is not clear that these increased rates were from intentional misuse.…”

Section: Introductionmentioning

confidence: 99%

Prescription opioid and benzodiazepine misuse is associated with suicidal ideation in older adults

Schepis

Simoni

McCabe

2018

Int J Geriat Psychiatry

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Objectives: Suicide in older adults is a major public health issue. Past research across the US adult population has linked prescription medication misuse with suicidal ideation. No work has evaluated associations between prescription opioid or benzodiazepine misuse and suicidal ideation in older adults, and this work aimed to address that gap. Methods/Design: Data were from adults 50 years and older participating in the 2015-16 National Survey on Drug Use and Health (n = 17,608). Design-based logistic regression evaluated links between any past-year prescription opioid or benzodiazepine use without misuse or prescription misuse and past-year suicidal ideation, after controlling for sociodemographic, physical health, mental health and substance use correlates associated with suicidal ideation. Results: After controlling for all correlates, past-year use without misuse of prescription opioids or benzodiazepines were not associated with past-year suicidal ideation in older adults. In contrast, past-year opioid misuse (AOR = 1.84, 95% CI = 1.07-3.19) and benzodiazepine misuse (AOR = 2.00, 95% CI = 1.01-3.94) were significantly associated with past-year suicidal ideation, even after controlling for all covariates. While 2.2% of US older adults not engaged in either opioid or benzodiazepine misuse reported past-year suicidal ideation, 25.4% of those who misused both medication classes endorsed such suicidality (AOR = 4.73, 95% CI = 2.07-10.79). Conclusions: Both past-year prescription opioid and benzodiazepine misuse are associated with past-year suicidal ideation in US older adults. Clinicians encountering older adult patients at-risk for or engaged in prescription medication misuse also should screen for suicidality.

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“…Opioids, a class of drugs that includes both illicit substances (e.g., heroin) and prescription medications (e.g., morphine, oxycodone, and codeine), account for over 2.5 million substance use disorders in the United States every year (American Society of Addiction Medicine [ASAM, ]) and resulted in over 33,000 overdose deaths in 2015 and 34,000 in 2016 (ASAM, ). In addition, although individuals with substance use disorders in general have been found to exhibit a 54% increase in risk for death by suicide (Bohnert, Ilgen, Louzon, McCarthy, & Katz, ; Poorolajal, Haghtalab, Farhadi, & Darvishi, ; Schneider, ), there is increasing evidence that opioid use disorders in particular are associated with heightened suicidal ideation, suicide attempts, and completed suicide (Ashrafioun, Bishop, Conner, & Pigeon, ; Bohnert et al., ; Kuramoto, Chilcoat, Ko, & Martins, ; Wilcox, Conner, & Caine, ). For example, it is estimated that 32–48% of opioid‐dependent individuals attempt suicide at least once (Roy, ; Trémeau et al., ), and individuals who seek treatment for opioid dependence are 13.5 times more likely to die by suicide than the general population (Wilcox et al., ).…”

mentioning

confidence: 99%

The Role of Opioid Use in Distinguishing between Suicidal Ideation and Attempts

Anestis

Tull

Butterworth

et al. 2019

Suicide & Life Threat Behav

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Objective Opioid use disorders are associated with heightened suicidal ideation, suicide attempts, and suicide death. This study aimed to examine the extent to which opioid differentiates between those with suicide attempts from those with lifetime suicidal ideation but no history of attempt. Methods Participants were drawn from the US National Guard and a residential substance use treatment facility. Multinomial logistic regression was utilized to determine the extent to which a lifetime history of nonmedical opioid use differentiated between (1) individuals with no lifetime history of suicidal ideation or attempt, (2) individuals with a history of suicidal ideation but no attempt, and (3) individuals with a history of at least one suicide attempt. Results History of opioid use among National Guard personnel and opioid use disorders among substance‐dependent patients were associated with an increased likelihood of having at least one suicide attempt relative to both a history of suicidal ideation but no attempts and no history of ideation or attempts. Findings held when accounting for lifetime nonmedical use of other substances and the presence of other lifetime substance use disorders. Conclusions Results highlight the importance of assessing for suicide risk among opioid users.

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Frequency of prescription opioid misuse and suicidal ideation, planning, and attempts

Cited by 93 publications

References 30 publications

Trends and mental health correlates of nonmedical opioid use among criminal justice-involved African American men

Trends and mental health correlates of nonmedical opioid use among criminal justice-involved African American men

Prescription opioid and benzodiazepine misuse is associated with suicidal ideation in older adults

The Role of Opioid Use in Distinguishing between Suicidal Ideation and Attempts

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