Social Media Recruitment of Survivors Who Have Lost Someone to Suicide with Pain Following a Prescription Opioid Change

Abstract

Reports have found associations between prescription opioid stoppage and suicide, without detail as to how such suicides happen. Psychological autopsies could be revelatory but require enlisting survivors who may distrust health systems. This pilot assessed the feasibility of using social media to recruit survivors. A multi-disciplinary team created a 45-item online survey for respondents reporting loss of someone to suicide after prescription opioid change. It includes 4 screeners (eg., Do you believe that someone close to you died by suicide after a change in pain medication?). Other items include relationship to the decedent and characteristics of the death. Recruitment involved postings on Facebook, Reddit, Twitter, usually asking "Have you lost someone with pain to suicide?" Over 10 months, 48 respondents passed the screeners and reported both a gender (30 male, 18 female) and race (42 White, 6 Other) for a decedent, from 30 states. For these 48, 38 respondents were "confident" the death was an "intentional act". Among them, 31 affirmed that they "consider yourself to be in a family relationship" with the decedent, while 17 responded "No". Of those 31, 21 endorsed typical family relationships (eg. parent, spouse). However, 6 of 31 described the relationship as "friend", 4 as "self". Among 41 respondents, 35 said opioids had been reduced, but 2 said they had been increased, and 4 avowed not knowing. Of 45 who reached the end of the survey, 35 agreed to be contacted for future study. Public recruitment to engage people who have lost someone to suicide is possible. Respondents may include friends, family, and persons who have not died by suicide, but may be at risk. Formal research beyond pilot stage, as is planned, requires professional outreach, as well as safety plans to respond to persons who may be thinking about suicide. Funding provided via an internal grant from the University of Alabama's School of Medicine.