TY - JOUR
T1 - Opioid Use and Misuse and Suicidal Behaviors in a Nationally Representative Sample of US Adults
AU - Samples, Hillary
AU - Stuart, Elizabeth A.
AU - Olfson, Mark
N1 - Funding Information:
Author affiliations: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York (Hillary Samples); Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland (Elizabeth A. Stuart); and Department of Psychiatry, Columbia University Irving Medical Center, New York, New York (Mark Olfson). This work was funded by the National Institute on Drug Abuse (grant T32 DA031099) and the Institute of Education Sciences, US Department of Education (grant R305D150001). H.S. has received consulting fees from the American Society of Addiction Medicine.
Publisher Copyright:
© 2019 The Author(s).
PY - 2019/7/1
Y1 - 2019/7/1
N2 - Prior research has shown associations between opioid misuse and suicidal behaviors, but the relationship between medical opioid use and suicidal behaviors is not known. We assessed associations of opioid use and misuse with suicidal ideation, suicide plans, and suicide attempts among adults aged 18-64 years (n = 86,186) using nationally representative cross-sectional data from the 2015 and 2016 administrations of the National Survey on Drug Use and Health. We used logistic regression to estimate associations between opioid use/misuse and suicidal behaviors and propensity score-weighted logistic regression analysis to examine the counterfactual scenario in which persons with misuse had instead not misused opioids. In propensity score-weighted analyses, compared with opioid misuse, opioid use without misuse was associated with lower odds of suicidal ideation (odds ratio (OR) = 0.57, 95% confidence interval (CI): 0.45, 0.72) and suicide plans (OR = 0.53, 95% CI: 0.35, 0.80), and no use was associated with lower odds of suicidal ideation (OR = 0.62, 95% CI: 0.49, 0.80), suicide plans (OR = 0.56, 95% CI: 0.39, 0.79), and suicide attempts (OR = 0.54, 95% CI: 0.33, 0.89). These findings suggest that opioid misuse is associated with greater odds of suicidal behaviors, but opioid use without misuse is not. Compared with persons with opioid misuse, similar persons without misuse have a reduced risk of suicidal behaviors. Clinical and public health interventions should focus on preventing misuse of opioids.
AB - Prior research has shown associations between opioid misuse and suicidal behaviors, but the relationship between medical opioid use and suicidal behaviors is not known. We assessed associations of opioid use and misuse with suicidal ideation, suicide plans, and suicide attempts among adults aged 18-64 years (n = 86,186) using nationally representative cross-sectional data from the 2015 and 2016 administrations of the National Survey on Drug Use and Health. We used logistic regression to estimate associations between opioid use/misuse and suicidal behaviors and propensity score-weighted logistic regression analysis to examine the counterfactual scenario in which persons with misuse had instead not misused opioids. In propensity score-weighted analyses, compared with opioid misuse, opioid use without misuse was associated with lower odds of suicidal ideation (odds ratio (OR) = 0.57, 95% confidence interval (CI): 0.45, 0.72) and suicide plans (OR = 0.53, 95% CI: 0.35, 0.80), and no use was associated with lower odds of suicidal ideation (OR = 0.62, 95% CI: 0.49, 0.80), suicide plans (OR = 0.56, 95% CI: 0.39, 0.79), and suicide attempts (OR = 0.54, 95% CI: 0.33, 0.89). These findings suggest that opioid misuse is associated with greater odds of suicidal behaviors, but opioid use without misuse is not. Compared with persons with opioid misuse, similar persons without misuse have a reduced risk of suicidal behaviors. Clinical and public health interventions should focus on preventing misuse of opioids.
KW - attempted suicide
KW - nonmedical medication use
KW - opioid abuse
KW - opioids
KW - prescription drug misuse
KW - suicidal ideation
KW - suicide
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U2 - 10.1093/aje/kwz061
DO - 10.1093/aje/kwz061
M3 - Article
C2 - 30834448
AN - SCOPUS:85064317612
SN - 0002-9262
VL - 188
SP - 1245
EP - 1253
JO - American journal of epidemiology
JF - American journal of epidemiology
IS - 7
ER -