Critical link between pain intensity and suicide

VA study uncovers critical link between pain intensity and suicide attempts –  Oct 2019

Here’s the earthshattering conclusion of a new study:

New study finds pain intensity is a telling risk factor for suicide!

Apparently, this is BIG news for the medical community. They’ve never found such results before – probably because no one has studied it.

It saddens me that most people still don’t understand how devastating chronic pain becomes, how it upends lives and sometimes cuts them short. 

I believed no such studies were necessary because it was so obvious (like those studies on whether parachutes help survival when jumping out of an airplane). To me, that unrelieved long-term intense pain leads to suicide is simply common sense:

More Pain == More Death Wish

VA’s Behavioral Health Autopsy Program: Executive Summary reports pain is the most common factor Veterans experience before they die by suicide. The VISN 2 Center of Excellence (CoE) for Suicide Prevention studied the link between reported pain intensity and suicide attempts.

The results may uncover how effective pain treatment can be a critical suicide prevention tactic.

This is exactly what I’ve been saying for years: Pain Management IS Suicide Prevention!

Managing pain in daily life

Veterans have several treatment options through VA to cope with pain and reduce pain intensity. 

They then describe all the ways the VA will “help them with their pain”, trying everything else first, and if none of that works, the article claims that opioids “may be used under close monitoring”.

This sounds eminently reasonable, but if they were really doing offering opioid therapy as a last resort, we wouldn’t be hearing of so many veterans committing suicide because their pain is more than they can tolerate.

Nonmedication interventions are considered first-line treatments. They include physical therapy, cognitive behavioral therapy for chronic pain and chiropractic care. 

Medication-based treatments include nonsteroidal anti-inflammatory medications and injections. Examples are cortisone for low back pain and botulinum toxin for migraines. 

Opioids may be used under close monitoring when they are taken appropriately and the benefits outweigh the risks.

Strategies

Strategies that improve psychological well-being can also help Veterans cope with pain in everyday life. Veterans can discuss the following tactics with care providers to see which may work best:

• Be honest about the pain you’re experiencing [though many doctors will simply not believe you or claim you’re catastrophizing]
• Pace your activities  [do even less of what you enjoy on the rare occasions that you can do it at all]
• Explore mindfulness  [proven to be useless for most kinds of chronic pain – Mindfulness Rx Allows Doctors to Ignore Pain]

Study Findings

I’m sure no pain patients are the slightest bit surprised at these “findings” because it’s the truth we face every day when we’re wrestling with our pain. A life with constant disabling pain, almost guaranteed to worsen as we age, can feel miserable and hopeless.

Based on data from 2012–2014, moderate and severe pain over the course of a year increased the risk of a suicide attempt, even after considering other factors like a Veteran’s history of suicide attempts.

those with higher pain intensity had lower survival rates than those who had mild pain or no pain at all.

This close correlation between pain intensity and suicide risk and death rates suggests that reducing pain, or the perception of that pain, can help prevent Veteran suicide.

It’s good news that the VA has finally proven to itself that pain levels are a serious matter and far more than just “experiencing some discomfort”.

I don’t understand why it’s so hard for “normal people” to understand that pain can become so intense and inescapable that death seems like a relief.

Author: Lisham Ashrafioun, Ph.D., is a research investigator at the VA Center of Excellence for Suicide Prevention at the VA Finger Lakes Healthcare System and an Assistant Professor of Psychiatry at the University of Rochester.