Prevalence and correlates of suicidal thoughts and suicide attempts in people prescribed pharmaceutical opioids for chronic pain

Objectives: The main objectives of the paper were (1) to examine the prevalence of suicidality in a large community-based chronic pain sample taking prescribed opioids for chronic pain; and (2) to examine general and pain-specific factors that predict such ideation, and the transition from ideation to making a suicide attempt (ideation-to-action).

Methods: Baseline data from the Pain and Opioids IN Treatment (POINT) study with a cohort of 1514 community-based people prescribed opioids for chronic non-cancer pain across Australia.

Results: Past 12 month suicidal ideation was reported by 36.5% of the cohort and 16.4% had made a lifetime suicide attempt (2.5% in the last 12 mo), after the onset of their pain condition. Suicidal ideation in the past 12 months was independently associated with a past suicide attempt (AOR = 4.82, 95%CI 2.43-9.56) and past 12 month depression (AOR = 4.07, 95%CI 1.88-8.78). Only a lower pain-self efficacy score was independently associated with past 12 month ideation-to-action (AOR 0.98, 95%CI0.88-0.99). Notably, only general suicide risk factors were associated with 12 month suicidal ideation; but for past-year ideation-to-action, pain specific factors also had independent associations.

Discussion: The study is one of the first to comprehensively examine general and pain-specific risk factors for suicidality in a large chronic pain sample in which suicidal ideation was common. A low pain self-efficacy score was the only factor independently associated past 12 month ideation-to-action.