Prevalence and Correlates of Suicidal Thoughts and Suicide Attempts in People Prescribed Pharmaceutical Opioids for Chronic Pain.

Abstract

The main objectives of the paper were (1) to examine the prevalence of suicidality in a large community-based chronic pain sample taking prescribed opioids for chronic pain; and (2) to examine general and pain-specific factors that predict such ideation, and the transition from ideation to making a suicide attempt (ideation-to-action). Baseline data from the Pain and Opioids IN Treatment (POINT) study with a cohort of 1514 community-based people prescribed opioids for chronic noncancer pain across Australia. Past 12-month suicidal ideation was reported by 36.5% of the cohort and 16.4% had made a lifetime suicide attempt (2.5% in the last 12 mo), after the onset of their pain condition. Suicidal ideation in the past 12 months was independently associated with a past suicide attempt [adjusted odds ratio (AOR)=4.82; 95% confidence interval, 2.43-9.56] and past 12-month depression (AOR=4.07, 95% confidence interval, 1.88-8.78). Only a lower pain self-efficacy score was independently associated with past 12-month ideation-to-action (AOR=0.98, 95%CI0.88-0.99). Notably, only general-suicide risk factors were associated with 12-month suicidal ideation; but for past year ideation-to-action, pain-specific factors also had independent associations. The study is one of the first to comprehensively examine general and pain-specific risk factors for suicidality in a large chronic pain sample in which suicidal ideation was common. A low pain self-efficacy score was the only factor independently associated past 12-month ideation-to-action.