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.
“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:
- Opioids enhance some antidepressants
- Opiods as Antidepressants
- Interaction of antidepressants and body’s opioid system
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.
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:
“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.