Opioids Playing Key Role in Rising Suicide, Overdose Rates

January 23, 2019

Deaths from suicide and unintentional overdose in the United States more than doubled in 17 years—from 41,364 in 2000 to 110,749 in 2017. And the rate of the 2 causes of death grew from 14.7 to 33.7 per 1000 Americans over the same time period.

Investment in programs shown to prevent and treat opioid addiction, as well as better pain management, are essential in reversing the trend, according to a recent review article in The New England Journal of Medicine. In the piece, University of Michigan researchers Amy S.B. Bohnert, PhD, and Mark A. Ilgen, PhD, presented evidence linking overdose, suicide, chronic pain, and opioids bought both legally and illegally.

“The use of potentially lethal drugs such as opioids has a clear, direct relationship to the risk of unintentional overdose. Perhaps less well known, opioids also are linked to suicide risk,” the authors wrote. “Furthermore, opioid use disorders have a distinctly strong relationship with suicide as compared with other substance use disorders.”

Chronic Pain May Contribute to Suicide

In 2017, more than two-thirds of unintentional overdose deaths involved opioids, according to the authors. Opioids were also implicated in a third of suicides by overdose.

While the article called for further research to identify populations most at risk of unintentional and deliberate opioid overdose, it also recommended several evidence-based interventions with the potential to prevent opioid-related deaths, including:

  • slow, patient-centered tapering of opioids for people on high-dose regimens or who are showing signs of misuse, combined with care to reduce suicide and overdose risk;

  • naloxone for friends and family members of such patients; and

  • greater availability of medication-assisted treatment for opioid use disorder and treatment for mental health conditions.

“[I]nterventions that address the shared causes and risk factors, such as programs to improve the quality of pain care, expand access to psychotherapy, and increase access to medication-assisted treatment for opioid use disorders, have the potential to be high-value investments by addressing both problems simultaneously,” Drs. Bohnert and Ilgen wrote.

—Jolynn Tumolo

References

Bohnert ASB, Ilgen MA. Understanding links among opioid use, overdose, and suicide. The New England Journal of Medicine. 2019;380(1):71-79.

Gavin K. Opioid-related suicides and overdose deaths have more than doubled since 2000 [press release]. Ann Arbor, Michigan: Michigan Medicine; January 10, 2019.