Mental illnesses such as depression and post-traumatic stress disorder are known risk factors for suicide. However, a new study from the University of Washington identified another factor that may increase the risk of suicide: prescription opioid use.
According to the study, individuals with depression and PTSD are more likely to be prescribed opioids — for longer periods and in higher doses — for chronic pain than individuals who do not suffer from these mental illnesses.
This led the team to analyze National Vital Statistics System data to identify trends in opioid-related suicides. Their findings: Suicides in which opioid overdose was the cause of death more than doubled from 1999 to 2014.
“These analyses underscore the need for health care providers to assess suicidal risk in patients receiving opioids,” the study authors wrote.
A diagnosis of substance use disorder or borderline personality disorder was also linked to more frequent use of prescription opioids at higher doses.
Each year, more than 44,000 people die as a result of suicide. It’s the 10th leading cause of death, according to the American Foundation for Suicide Prevention.
Poisoning deaths, which include drug overdoses, accounted for 15.4 percent of all suicides in 2015. Opioid overdose is involved in a smaller percentage of that number.
However, according to National Center for Health Statistics data, the percentage of opioid-related suicides grew from about 2 percent in 1999 to 4 percent in 2014. Gender, age and race all factored into these rate increases.
Women attempt suicide at three times the rate of men, but men die more often as a result of suicide. Women are also more likely to be prescribed opioids than men. Therefore, the study’s finding that more women were committing suicide using opioids than men was a logical conclusion reinforced with data.
Middle-aged Americans, who generally have the highest suicide rates —19.6 percent of suicides in 2015 were committed by persons aged 45 to 64 — also saw an increase in rates of suicide death due to opioids.
Opioid-related suicides also increased sharply among white individuals, who traditionally have had higher suicide rates than nonwhite individuals.
One of the most striking findings of the study is that suicide deaths related to prescription opioids accounted for 97.7 percent of all opioid-related suicides. Heroin, also considered an opioid, only accounted for 0.3 percent of those deaths. This underscores the immensity of the prescription opioid epidemic.
The researchers at the University of Washington connected the dots between suicide, opioid use and mental illness. Mental illness and suicide are closely linked, and those with mental illness — especially women— are more likely to be prescribed opioids to manage chronic pain.
Depression, anxiety, substance use disorders and other mental illnesses are the most common risk factors for suicide. However, other conditions can also increase the risk that someone will attempt or commit suicide. These include chronic pain and other serious health conditions for which opioids might be prescribed.
The team at the University of Washington also suggested that while the presence of firearms in one’s home is also a contributing risk factor in suicide, possession of opioids in the home might also be a significant risk factor to consider.