Opioid Treatment Programs to Provide Suicide Care

Opioid Treatment Programs Gear Up to Provide Suicide Careby Christine Vestal– Apr 2019

It’s long been suspected that the nation’s unprecedented drug overdose epidemic and sharply rising suicide rates are linked.

Now health researchers are finding concrete evidence that the two preventable causes of death — which are among the top 10 in the United States — are intrinsically related:

  • People with an opioid addiction are at much higher risk for suicide than the rest of the population; and
  • opioid use was a contributing factor in more than 40% of all suicide and overdose deaths in 2017, according to data from the U.S. Centers for Disease Control and Prevention. [Note: this identifies opioids only as *contributing* to overdose deaths]   

Pain patients are also more likely to commit suicide, yet this article only talks about problematic “opioid abuse” and says nothing about how the withdrawal of opioid therapy is resulting in numerous suicides.  

Suicide prevention advocates have been pushing the addiction treatment community to address the substantial overlap by evaluating all patients for suicide risk and employing preventive techniques for those who need it.

Some drug treatment programs already screen patients for suicide and offer suicide prevention therapies. Soon, all treatment programs will have to meet the standard to maintain their accreditation from the Commission on Accreditation of Rehabilitation Facilities.

Well, this is news to me. First, there were pill mills, and now there are “recovery mills”. I’m happy to see that the addiction-recovery industry will finally start being regulated.

Many of these unregulated and wildly profitable “programs” are a scam to fleece insurance companies, using tactics like

  • selecting only patients with excellent insurance coverage (the operators themselves sometimes apply and pay the premiums),
  • collecting thousands in rent for housing patients in crowded residences without supervision (where there’s often rampant drug abuse),
  • providing no medical care (they don’t pay for appropriate medical staff), and
  • pressuring patients to relapse deliberately so insurance will pay for them to start the program over and over again.

The patient is only “cured” when their insurance stops paying.

According to the National Action Alliance, other health care organizations that have used its suicide prevention approach saw a 60% to 80% reduction in deaths.

Michael Hogan, a behavioral health consultant [estimates], at least 7,000 people in the care of publicly funded behavioral health programs die by suicide each year.

Nationwide, more than 47,000 Americans died by suicide in 2017 and more than 70,000 died from a drug overdose, according to the Centers for Disease Control and Prevention.

Looks like it was 41,000 in 2015, but has risen to 47,000 in 2017, a significant increase of almost 15% in just 2 years.

Safety Plans

When people feel hopeless and in distress, they may resort to drugs. But they also may resort to suicide,” Johnson said.

Many people are feeling “hopeless and in distress” from a *lack* of drugs because they are no longer allowed to take opioid medication for their intractable pain.

“The more we can do to create hope for people and help them stay connected to others, the better they’ll do overall. We need to address the root causes.”

For pain patients that have been forcibly tapered this is very simple: prescribe them an opioid medication at a dose that is sufficient to control their pain.

In fact, many of the therapeutic techniques used to prevent suicide in people deemed at risk of harming themselves are similar to treatments for people who are addicted to drugs and alcohol, Johnson said.

But with suicide, there’s an additional need to develop a safety plan to help people avoid suicide when they experience powerful urges to end their pain, said Julie Goldstein Grumet, a clinical psychologist

When a person is suffering so much intractable pain that they would rather die than live with it, it seems obvious to me that they should be given effective medication for it, opioids, which also have an antidepressant effect:

Safety plans, which have been used for years in some hospital emergency departments, include both a list of contacts to call when suicidal urges occur and methods of preventing a patient’s access to lethal means, such as locking up guns and giving the key to another person.

Until recently, there was little evidence that safety plans or any other suicide prevention methods worked.

But a study published in September, led by a researcher at Columbia University, showed that using safety plans for people who were discharged from Veterans Health Administration hospital emergency departments after attempting suicide, and following up with those patients through regular phone calls, cut future suicide attempts in half.

Overlapping Causes

Using data from the CDC, the researchers found that combined deaths from suicides and unintentional overdoses jumped from about 41,000 in 2000 to nearly 111,000 in 2017

When accounting for an increase in U.S. population during that time, the researcher found that the two causes of death had risen from roughly 15 per 100,000 people to nearly 34 per 100,000 in 17 years.

While the drug warriors have our government agencies so narrowly focused on drug overdoses, they are ignoring the fact that there are many more deaths from other causes, especially iatrogenic deaths from medical errors:

440,000 deaths each year from medical errors in the U.S.:

“Even with the stun­ning fact that 1 in 10 patient deaths is esti­mated to be caused by errors in diag­no­sis, the main­stream media cov­ered the story for a day. And then moved on.”

This is almost ten times the rate of suicide – and I’ll bet most of the increase has been in the last few years when more and more Americans were so unhappy with their lives that they succumb to addiction or suicide.

More than 2 million Americans are addicted to opioid painkillers or heroin, and about a fifth of them have received treatment, according to the U.S. Substance Abuse and Mental Health Services Administration.

“It makes sense,” Ahmedani said, “to provide high-intensity suicide care for everyone in this population.

The treatment field has been so under-resourced and so slammed and so focused on its own mission — keeping people from relapsing — that it hasn’t focused on the suicide risk among people in its care.”

A 2018 analysis co-authored by National Institute on Drug Abuse Director Nora Volkow showed that between 20% and 30% of opioid overdose deaths counted as accidents are suicides, based on forensic evidence.

Adding those uncounted deaths to the already steeply rising number of people who die by suicide — more than 47,000 in 2017, according to the American Foundation for Suicide Prevention — underscores the need to address as one the entwined public health crises of addiction and suicide, Hogan said.

9 thoughts on “Opioid Treatment Programs to Provide Suicide Care

  1. peter jasz

    I’d think that a Patient Health/Welfare blog -such as this one- would concern itself with intractable pain patients; how to find answers, help -and desperately needed pain relief.

    By introducing illegally-obtained street drug narcotics (and the deaths that result), creates a narrative that ultimately involves medically-managed opiate analgesia -with devastating consequence for intractable pain sufferer’s.
    THAT, must stop immediately: As the notion/headlines of an “Opiate Epidemic” that is complete BS. Consider that cocaine, Meth abuse/OD’s are 100X greater than opiate-derived casualties. AND that alcohol IS RESPONSIBLE for 1,000X greater casualties/deaths.

    In other words, if we have an opioid epidemic, then there is an out-of-control pandemic (going back decades) and where are the alarm bells here ? Or the headlines ? The finger-pointing, crack-downs, threats, raids and harassment ? Why opiate analgesia ?

    Perhaps it would be both wise and telling if the data reported how many OD’s were from opiate use alone – and then begin analysing. IF that were done, I’m confident the numbers/or percentage would be near zero, (i.e. non-existent).

    It’s time to reveal truths, find immediate help/aid for those so suffering and crack-down on the brutal government/policy abuses that is destroying modern, civilized culture, rights, freedoms and basic constitutional protections.

    pj

    Liked by 1 person

    Reply
    1. Zyp Czyk Post author

      Perhaps you misunderstand the blog format. All the italicized indented text is quoted from the article (linked to in the title). My comments are in regular type starting at the margin.

      However, if you can’t see any difference between those two text types, I’d like to know what kind of device you’re using to read this so I can tell WordPress that text is being displayed on that device type without formatting.

      Liked by 1 person

      Reply
      1. peter jasz

        Lol. It’s quite the read when the reader has to fight through/make sense of the author’s “style”; a hybrid (of sorts).

        Regardless, my point was simply to stress the importance of staying-on -track (i.e.concentrating on the health/welfare of patients) as opposed to re-hashing a poisoned narrative (the ills of under-ground society’s illicit drug use/OD’s) when the blog’s raison d’tere (I suspect) is the legitimate health concerns of tortured, intractable pain sufferer’s.

        All too often, this wildly inaccurate and fabricated ‘Opiate Crisis/Epidemic’ (tagline) derails and misleads the public into a false narrative; with deadly repercussions (particularly to intractable pain victims).
        It’s time to re-focus and clarify; lives are in jeopardy. As is the health and future, of a nation.

        pj

        Liked by 1 person

        Reply
        1. Zyp Czyk Post author

          Yes, I agree – I’m kinda sick of “re-hashing a poisoned narrative” too.

          When I see such articles I get so outraged that it’s become a habit to refute them point by point. But I know such rebuttals would be more relevant if they were written as comments on the website of the article itself.

          But I’m nervous about writing in that kind of public sphere (some heavily-trafficked popular website) where I’d be exposed to vast numbers of others, some of which will vehemently disagree with me. Anyone can jump on my comments and rip them to shreds without proof – and I’m so darn sensitive that I’m not sure I could handle the nasty personal attacks that are so common these days.

          Still, I do understand my writing would be far more useful “out there” because I’m only “preaching to the choir” here.

          Liked by 2 people

          Reply
          1. DREW5000G

            Have a try, step out the comfort zone and spread your work further because it deserves a wider audience, you do so much for others, as for the negative stuff, ignore or nothing to stop you reverting back. You should try to find a bigger platform cos your stuff is important to many. The stars will guide you

            Liked by 3 people

            Reply
            1. Zyp Czyk Post author

              Wow, Drew, thank you for the encouragement!

              Your comment really gives me a push to venture into new territory. I’m not sure what will develop, but you’re right: the stars will guide me – and this was the first one.

              Liked by 3 people

  2. canarensis

    “Many people are feeling “hopeless and in distress” from a *lack* of drugs because they are no longer allowed to take opioid medication for their intractable pain.”
    Testify, Sister!

    “More than 2 million Americans are addicted to opioid painkillers or heroin”
    Ain’t it great that they conflate the two, as if there’s no difference? The New Narrative. And…where in the hell did they get the number? the phrase “out of their fundament” springs to mind.

    Liked by 1 person

    Reply
  3. louisva

    Zyp, I totally understand your feelings about writing to a larger audience. I do understand; however; like Drew, I find your writing to be some of the best around and I would also like to see it on “National Pain Report,” and many more. Your writing and that of my wife, Kristen is poignant, to the point, from the heart, yet readable by the lay public. Wish us luck! Tomorrow, Kristen and I and three other Virginia families will be meeting with Sen. Kaine’s staff to discuss how the guidelines adopted by Virginia are hurting chronic, intractable pain patients. Sen. Kaine is a member of the ‘HELP Committee (health, education, labor, and pension). I hope that I will be able to attend but I never know from day to day how I’m going to feel. I’m sure you know that feeling well.

    Liked by 2 people

    Reply
    1. Zyp Czyk Post author

      Thank you so much for your compliments and encouragement! I’m touched at how people I only know online express so much support for me.

      Whoo-boy, you are brave to venture into “the lion’s den” of politicians, cold-blooded schemers who are using their anti-opioid proposals to gain votes. I doubt they’d be nearly as concerned about opioids if “fighting the opioid crisis” hadn’t become a political strategy. I hope you’ll be able to make it and give them the facts straight from “the horse’s mouth”.

      I saw some of Kristen’s writing on the Nat Pain Report too. She thoroughly (with evidence) explains many of my own arguments against and objections to the current anti-opioid frenzy.

      If only facts mattered to people anymore…

      Liked by 1 person

      Reply

Other thoughts?

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.