Substance use and suicide outcomes among self-injured trauma patients

Karnick, Aleksandr T.; Caulfield, Nicole M.; Bauer, Brian W.; Martin, Rachel L.; Kaufman, Elinore J.; Winchell, Robert J.; Capron, Daniel W.

doi:10.1016/j.drugalcdep.2021.108906

Cited by 4 publications

(3 citation statements)

References 45 publications

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“…Presence of a major psychiatric disorder was associated with firearm attempts relative to controls and with admission to psychiatric services post-discharge; however, we did not find increased risk of attempt among individuals with AUD or SUD. While previous research has indicated that presence of a major psychiatric condition, AUD, or SUD is associated with increased suicide risk, (Conner, Bridge, et al, 2019;Hawton & van Heeringen, 2009;Schneider, 2009;Wilcox et al, 2004) our findings suggest that chronic substance use may inhibit the practical capacity for suicide leading to reduced ability or intent to enact more fatal attempt methods (Karnick et al, 2021;Klonsky & May, 2015). Further, presence of a major psychiatric disorder, AUD, SUD, and being a smoker were also associated with reduced mortality risk.…”

Section: Discussioncontrasting

confidence: 55%

Injury characteristics and circumstances of firearm trauma: Assessing suicide survivors and decedents

Karnick

Bond

Kaufman

et al. 2022

Suicide & Life Threat Behav

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Introduction Despite representing fewer than 5% of suicide attempts, firearms account for over half of deaths. Yet there is little clinical information regarding firearm attempts, particularly survivors. We assessed clinical factors differentiating firearm suicide survivors from decedents, firearm attempters from other methods, and firearm attempters from similarly injured trauma patients. Methods We used clinical data from the National Trauma Data Bank (2017) to assess firearm suicide attempts using cross‐sectional and case–control designs. We used logistic and multinomial regression to compare groups and assess firearm type and discharge destination. Results Older age, being uninsured, and injury location were associated with increased mortality among firearm attempters. Older age, White race, male sex, and being uninsured were associated with firearm attempts. Major psychiatric disorders were associated with firearm attempts and using a rifle or shotgun. Major psychiatric disorders, female sex, and smoking were associated with psychiatric discharge. Black and other race were associated with law enforcement discharge, and Black race was associated with lower odds of psychiatric discharge. Uninsured patients had lower odds of discharge to long‐term care, psychiatric, or rehabilitation facilities. Conclusions This study identifies factors associated with firearm suicide and includes indicators of disparities in health services for patients at high risk of suicide death.

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Section: Discussioncontrasting

confidence: 55%

Injury characteristics and circumstances of firearm trauma: Assessing suicide survivors and decedents

Karnick

Bond

Kaufman

et al. 2022

Suicide & Life Threat Behav

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“…Globally, over 800,000 people commit suicide every year ( World Health Organization, 2014 ), and suicide was recently listed as the main cause of premature death for adolescents suffering from psychosis ( Barbeito et al, 2021 ). Risk factors associated with suicide are complex and include the psychotic symptoms themselves ( Stefenson and Titelman, 2016 ; Hawton et al, 2005 ), substance and alcohol use ( Karnick et al, 2021 ; Kamali et al, 2000 ), the male sex ( Franklin et al, 2017 ), and socio-economic issues ( Song and Lee, 2016 ). Comorbid depression may contribute to suicidality ( Upthegrove et al, 2017 ; Hawton et al, 2013 ).…”

Section: Introductionmentioning

confidence: 99%

Association between cytokines and suicidality in patients with psychosis: A multicentre longitudinal analysis

Hoprekstad,

Skrede,

Bartz-Johannessen

et al. 2024

Brain, Behavior, & Immunity - Health

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“…Drug screening during the admission in trauma centres is the focal point of information gathering for substance use. Many studies used drug screening results to examine the effect of pre-injury substance use on the different clinical outcomes of trauma patients (Cowperthwaite and Burnett 2011 ; Andelic et al 2010 ; Karnick et al 2021 ; Cheng et al 2016 ; Yeung et al 2013 ; Culhane and Freeman 2020 ). As pre-injury substance use is one of the major contributors to traumatic injury, its effect on different health outcomes (e.g., mortality and cardiac complications) were studied previously (Cheng et al 2016 ; Culhane and Freeman 2020 ; Cannon et al 2014 ).…”

Section: Introductionmentioning

confidence: 99%

Opioid-related polysubstance use and its effect on mortality and health resource utilization among trauma patients

Khadka,

Bardes,

Al-Mamun

2023

Inj. Epidemiol.

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Background Pre-injury opioid use is common, but the effects of opioid-related polysubstance use on mortality and health resources utilization (HRU) have not been investigated yet. The objective of this study was to investigate the effects of opioid-related polysubstance use on mortality and HRU among patients in trauma centres in the US. Methods We conducted a retrospective cross-sectional study using the US National Trauma Databank from the year 2017 to 2019. Patients (≥ 18 years of age) who tested positive for opioids were included. Patients were analysed based on the number of substances used (i.e., opioids only, two substances (opioids + 1 substance), and three or more than three substances (opioids + ≥ 2 substances)), and polysubstance by type (i.e., opioids only, opioids and alcohol, opioids and stimulants, opioids and benzodiazepine, and other combinations). Multivariate logistic regression was used to determine the association between polysubstance use, mortality and HRU (i.e., need for hospital admission, ICU, and mechanical ventilation). Results Both polysubstance by number and type analyses showed that opioid-related polysubstance use was not significantly associated with mortality compared to opioids only. The odds of hospital admission were higher among the opioids and benzodiazepines group (OR 1.15, 95% CI 1.06–1.24, p < 0.01). The need for ICU was magnified using benzodiazepines and stimulants with opioids (OR 1.44, 95% CI 1.27–1.63, p < 0.01) when compared to the opioids only group. Conclusion Opioid-related pre-injury polysubstance use was associated with higher HRU in trauma patients. The evidence can be used by policymakers and practitioners to improve patient outcomes in trauma centers.

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Substance use and suicide outcomes among self-injured trauma patients

Cited by 4 publications

References 45 publications

Injury characteristics and circumstances of firearm trauma: Assessing suicide survivors and decedents

Injury characteristics and circumstances of firearm trauma: Assessing suicide survivors and decedents

Association between cytokines and suicidality in patients with psychosis: A multicentre longitudinal analysis

Opioid-related polysubstance use and its effect on mortality and health resource utilization among trauma patients

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