Suicidality in chronic pain

Suicidality in chronic pain: a review of the prevalence, risk factors and psychological links. – PubMed – May 2006

This study was done over 10 years ago, when the “crackdown” on opioids was just beginning. Since then, the situation for pain patients has become infinitely worse and many no longer have access to effective pain

Increasing numbers of pain patients are committing suicide because there is no other relief from their crushing pain. 

BACKGROUND:

This paper reviews and integrates the growing literature concerning the prevalence of and risk factors for suicidality in chronic pain.

METHOD:

A series of systematic searches in MEDLINE and PsychINFO identified 12 relevant articles examining suicide, suicide attempts, and suicidal ideation in chronic pain.

A selection of theoretical and empirical work identifying psychological processes that have been implicated in both the pain and suicide literature and which may be related to increased suicidality was also reviewed.

RESULTS:

Relative to controls, risk of death by suicide appeared to be at least doubled in chronic pain patients.

The lifetime prevalence of suicide attempts was between 5% and 14% in individuals with chronic pain, with the prevalence of suicidal ideation being approximately 20%.

Eight risk factors for suicidality in chronic pain were identified, including 

• the type,
• intensity and
• duration of pain and
• sleep-onset insomnia co-occurring with pain, which appeared to be pain-specific.
• Helplessness and hopelessness about pain,
• the desire for escape from pain, pain
• catastrophizing and avoidance, and
• problem-solving deficits

were highlighted as psychological processes relevant to the understanding of suicidality in chronic pain.

CONCLUSIONS:

Programmatic research is urgently required to investigate the role of both general and pain-specific risk factors for suicidality, to examine how the psychological processes mentioned above mediate or exacerbate suicidality, and to develop enhanced interventions for pain patients at risk.

This recommended research is still not being done. No one is counting the pain patients who have succumbed to suicide due to uncontrolled pain.

It’s convenient not to count these people, or to miss classify their suicides as overdose deaths because there are opioids in their body, there are traces of opioids in their body from their medication. The CDC counts any death of a person with any level of prescribed opioids in their system as an “overdose death“.

I’ve found many articles over the years proving that suicide risk is much higher for pain patients. The greatest risk is when patients are not believed and their pain is diagnosed as “psychogenic” and suicide is more likely the worse the pain is.

The CDC is trying to hide the problem:

• Suicide Emerges In The Opioid Epidemic
• Is Addiction or Undertreated Pain Causing Suicides?
• Many Opioid Overdoses May Be Suicides
• CDC Obscuring Rate Of Suicide Among Opioid Overdoses

The VA, in particular, has had so many suicides due to their brutal tapering of all patients taking opioids they have been forced to acknowledge them:

• VA Acknowledges Suicides
• Suicides from forced Opioid Reductions
• Impact of VA opioid reduction on suicides

Some general information on how chronic pain leads to suicide:

• Understanding Chronic Pain and Suicideo
• Chronic pain and suicide risk: A comprehensive review
• Emotional toll of Chronic Pain can lead to suicide

And when patients are diagnosed with “psychogenic” pain, ie. of “psychological” origin, which essentially means it’s “all in your head”:

• Chronic “Psychogenic” Pain Boosts Suicide Risk Most
• Psychogenic Pain and Iatrogenic Suicide
• Severe pain predicts greater likelihood of suicide

There many more posts on this subject going back years. You can find them all by using the “suicide” tag:  https://edsinfo.wordpress.com/tag/suicide/