• Pain Med · Aug 2023

    Suicidal thoughts and behaviors in Patients with Chronic Pain, with and without co-occurring Opioid Use Disorder.

    • Martin D Cheatle, Nicholas A Giordano, Kristy Themelis, and TangNicole K YNKY0000-0001-7836-9965Department of Psychology, University of Warwick, CV4 7AL Coventry, United Kingdom..
    • Department of Psychiatry and Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19106, United States.
    • Pain Med. 2023 Aug 1; 24 (8): 941948941-948.

    BackgroundIndividuals with chronic pain and a co-occurring substance use disorder present higher risk of suicide, but the individual and joint impacts of chronic pain and substance use disorders on suicide risk are not well defined. The objective of this study was to exam the factors associated with suicidal thoughts and behaviors in a cohort of patients with chronic non-cancer pain (CNCP), with or without concomitant opioid use disorder (OUD).DesignCross sectional cohort design.SettingPrimary care clinics, pain clinics, and substance abuse treatment facilities in Pennsylvania, Washington, and Utah.SubjectsIn total, 609 adults with CNCP treated with long-term opioid therapy (>/= 6 months) who either developed an OUD (cases, n = 175) or displayed no evidence of OUD (controls, n = 434).MethodsThe predicted outcome was elevated suicidal behavior in patients with CNCP as indicated by a Suicide Behavior Questionnaire-Revised (SBQ-R) score of 8 or above. The presence of CNCP and OUD were key predictors. Covariates included demographics, pain severity, psychiatric history, pain coping, social support, depression, pain catastrophizing and mental defeat.ResultsParticipants with CNCP and co-occurring OUD had an increased odds ratio of 3.44 in reporting elevated suicide scores as compared to participants with chronic pain only. Multivariable modeling revealed that mental defeat, pain catastrophizing, depression, and having chronic pain, and co-occurring OUD significantly increased the odds of elevated suicide scores.ConclusionsPatients with CNCP and co-morbid OUD are associated with a 3-fold increase in risk of suicide.© The Author(s) 2023. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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