Suicide Emerges In The Opioid Epidemic

Suicide Emerges In Understanding The Opioid Epidemic – Jan 2018 – Martha Bebinger

Measuring Suicide Among Patients Addicted To Opioids

Massachusetts, where Ohlman lives, began recognizing that some opioid overdose deaths are suicides in May 2017. The state says confirmed suicides are only about 2 percent of all overdose deaths, but Department of Public Health Commissioner Monica Bharel says it’s very difficult to determine the person’s true intent.

“For one thing, medical examiners use different criteria for whether suicide was involved or not,” Bharel says, and the “tremendous amount of stigma surrounding both overdose deaths and suicide sometimes makes it extremely challenging to piece everything together and figure out unintentional and intentional.”  

“[Based on the literature that’s available] it looks like it’s anywhere between 25 and 45 percent of deaths by overdose that may be actual suicides,” says Dr. Maria Oquendo, immediate past president of the American Psychiatric Association.

She points to one study of just prescription opioid overdoses that found 54 percent were unintentional; the rest were either suicide attempts or undetermined.

The opioid epidemic is occurring at the same time suicides have hit a 30-year high, but Oquendo says few doctors look for a connection.

“They are not monitoring it, they are probably not assessing it in the kinds of depths they would need to prevent some of the deaths,” says Oquendo, who chairs the department of psychiatry at the University of Pennsylvania.

In our modern world so infatuated with metrics, if such events are not counted and measured, in some way quantified, categorized (even wrongly), and broadcast, they remain invisible to policymakers.

Heroin overdoses had been receiving little attention for decades until PROP started adding them to prescription opioid overdoses and broadcasting this frighteningly large new number.

It makes no sense to conflate these 2 groups:

1. patients taking prescription opioid medication to relieve pain
2. people injecting themselves with illicit opioid powders

But that’s what PROP did and now, even though prescriptions numbers have been going down, injected illicit opioid overdoses are increasing.

‘Deaths Of Despair’

When doctors do look deeper into the reasons patients addicted to opioids become suicidal, some economists say they’ll find deep reservoirs of depression and pain.

Princeton economists Sir Angus Deaton and Anne Case tracked falling marriages rates, the loss of stable middle-class jobs and rising rates of self-reported pain in a seminal paper. The authors say opioid overdoses, suicides and diseases related to alcoholism are all often “deaths of despair.”

Original article: Suicide Emerges In Understanding The Opioid Epidemic