Suicidal thoughts and behaviors in patients with chronic pain, with and without co-occurring opioid use disorder

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Cheatle, MD, Giordano, NA, Themelis, K ORCID: https://orcid.org/0000-0002-0022-5272 and Tang, NKY, 2023. Suicidal thoughts and behaviors in patients with chronic pain, with and without co-occurring opioid use disorder. Pain Medicine, 24 (8), pp. 941-948. ISSN 1526-2375

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Official URL: https://doi.org/10.1093/pm/pnad043

Abstract

Background: Individuals with chronic pain and a co-occurring substance use disorder present higher risk of suicide, but the individual and joint impacts of chronic pain and substance use disorders on suicide risk are not well defined. The objective of this study was to exam the factors associated with suicidal thoughts and behaviors in a cohort of patients with chronic non-cancer pain (CNCP), with or without concomitant opioid use disorder (OUD).

Design: Cross sectional cohort design.

Setting: Primary care clinics, pain clinics, and substance abuse treatment facilities in Pennsylvania, Washington, and Utah.

Subjects: In total, 609 adults with CNCP treated with long-term opioid therapy (>/= 6 months) who either developed an OUD (cases, n = 175) or displayed no evidence of OUD (controls, n = 434).

Methods: The predicted outcome was elevated suicidal behavior in patients with CNCP as indicated by a Suicide Behavior Questionnaire-Revised (SBQ-R) score of 8 or above. The presence of CNCP and OUD were key predictors. Covariates included demographics, pain severity, psychiatric history, pain coping, social support, depression, pain catastrophizing and mental defeat.

Results: Participants with CNCP and co-occurring OUD had an increased odds ratio of 3.44 in reporting elevated suicide scores as compared to participants with chronic pain only. Multivariable modeling revealed that mental defeat, pain catastrophizing, depression, and having chronic pain, and co-occurring OUD significantly increased the odds of elevated suicide scores.

Conclusions: Patients with CNCP and co-morbid OUD are associated with a 3-fold increase in risk of suicide.

Item Type:	Journal article
Publication Title:	Pain Medicine
Creators:	Cheatle, M.D., Giordano, N.A., Themelis, K. and Tang, N.K.Y.
Publisher:	Oxford University Press (OUP)
Date:	August 2023
Volume:	24
Number:	8
ISSN:	1526-2375
Identifiers:	Number Type 10.1093/pm/pnad043 DOI 1879110 Other
Rights:	This is a pre-copyedited, author-produced version of an article accepted for publication in Pain Medicine following peer review. The version of record for Cheatle, M. D., Giordano, N. A., Themelis, K., & Tang, N. K. Y. (2023). Suicidal thoughts and behaviors in patients with chronic pain, with and without co-occurring opioid use disorder. Pain Medicine, 24(8), 941-948 is available online at: https://doi.org/10.1093/pm/pnad043
Divisions:	Schools > School of Social Sciences
Record created by:	Laura Ward
Date Added:	05 Apr 2024 09:30
Last Modified:	05 Apr 2024 09:30
URI:	https://irep.ntu.ac.uk/id/eprint/51200