Suicide Notes Suggest ‘Chilling’ Role of Chronic Pain – Perry Wilson, MD, MSCE – Sept 2018
Every time I talk about the opioid epidemic and how physicians should be careful prescribing opioids for chronic pain, I get a significant backlash from patients with chronic pain and their providers, who feel that opioids are the only thing keeping patients from suicide.
This concern is actually supported by the researcher’s analysis of 95 suicide notes from individuals with chronic pain;
64 of those notes stated that pain played a role in their decision to die by suicide—chilling and heartbreaking data.
On the other hand, access to opioids provides a suicide method. Indeed, 16.2% of the individuals with chronic pain died from opioid overdose, compared with just 3.9% of those without chronic pain.
Does chronic pain cause suicide?
The study can’t tell us for sure, but there are some hints that it may play such a role.
For example, individuals who died from suicide with chronic pain were less likely to have other suicide triggers, like a problem with an intimate partner, a recent argument, or a life stressor.
In other words, chronic pain may reduce the threshold for suicide.
Taken together, Petrosky says that one conclusion is clear: “It is essential that we improve chronic pain management through integrated patient-centered pain management that includes behavioral and mental health care, in addition to medication for these patients.”
It’s a blessing that the ever popular cause of suicide prevention is highlighting the role of chronic pain and drawing attention to our plight in the opioid crisis.