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Number of opioid overdoses and depression as a predictor of suicidal thoughts.

Authors
  • Brown, Lily A1
  • Denis, Cecile M2
  • Leon, Anthony3
  • Blank, Michael B4
  • Douglas, Steven D5
  • Morales, Knashawn H6
  • Crits-Christoph, Paul F7
  • Metzger, David S8
  • Evans, Dwight L9
  • 1 University of Pennsylvania, Department of Psychiatry, 3535 Market Street, Philadelphia, PA, 19104, USA. Electronic address: [email protected]
  • 2 University of Pennsylvania, Department of Psychiatry, 3535 Market Street, Philadelphia, PA, 19104, USA. Electronic address: [email protected]
  • 3 University of Pennsylvania, Department of Psychiatry, 3535 Market Street, Philadelphia, PA, 19104, USA. Electronic address: [email protected]
  • 4 University of Pennsylvania, Department of Psychiatry, 3535 Market Street, Philadelphia, PA, 19104, USA. Electronic address: [email protected]
  • 5 Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA; University of Pennsylvania, Department of Pediatrics, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA. Electronic address: [email protected]
  • 6 University of Pennsylvania, Department of Biostatistics, Epidemiology and Informatics, 423 Guardian Dr, Philadelphia, PA, 19104, USA. Electronic address: [email protected]
  • 7 University of Pennsylvania, Department of Psychiatry, 3535 Market Street, Philadelphia, PA, 19104, USA. Electronic address: [email protected]
  • 8 University of Pennsylvania, Department of Psychiatry, 3535 Market Street, Philadelphia, PA, 19104, USA. Electronic address: [email protected]
  • 9 University of Pennsylvania, Department of Psychiatry, 3535 Market Street, Philadelphia, PA, 19104, USA.
Type
Published Article
Journal
Drug and alcohol dependence
Publication Date
Jul 01, 2021
Volume
224
Pages
108728–108728
Identifiers
DOI: 10.1016/j.drugalcdep.2021.108728
PMID: 33971515
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Opioid use disorders are associated with increased risk of suicide thoughts, attempts, and death. We explored key variables from two theories of the development of suicidal thoughts and attempts (the interpersonal and three-step theories of suicide) to understand possible mechanisms underlying the association between opioid use and suicide risk. We hypothesized that interpersonal connections, variables reflecting psychological and physical pain, and variables that reduce fear of death (prior overdoses and risk-taking behaviors) would be associated with increased risk of thoughts of suicide. Participants (N = 141) were opioid users recruited from an epicenter of the opioid crisis in Philadelphia using a mobile research center and completed an interview to assess substance use, depression, medical comorbidities, and suicidal thoughts among other variables. Univariate analyses showed that prior history of overdose, diagnosis of depression, older age, homelessness, and interpersonal connection were each associated with increased likelihood of endorsing thoughts of death/suicide. Multivariable analyses revealed prior history of overdose and depression were the variables most strongly associated with risk for thoughts of suicide. Consistent with two theories of the development of suicidal thoughts and attempts, exposure to variables that reduce fear of death (e.g., overdoses) were associated with suicidal thoughts. In contrast, other risk-taking behaviors, medical comorbidities, and substance use were not key predictors of suicidal thoughts in this sample. Implications for targeted risk assessment among clinicians are discussed. Copyright © 2021 Elsevier B.V. All rights reserved.

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