1. Opioid use disorders, psychiatric comorbidities, and risk for suicide attempts among veterans seeking pain care
- Author
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Lisham Ashrafioun, Kotwoallama R A Zerbo, Todd M. Bishop, and Peter C. Britton
- Subjects
Adult ,Male ,medicine.medical_specialty ,Demographics ,Pain ,Suicide, Attempted ,Comorbidity ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,medicine ,Humans ,030212 general & internal medicine ,Bipolar disorder ,Psychiatry ,Applied Psychology ,Depression (differential diagnoses) ,Aged ,Proportional Hazards Models ,Veterans ,Suicide attempt ,Depression ,business.industry ,Opioid use ,Absolute risk reduction ,Middle Aged ,Opioid-Related Disorders ,medicine.disease ,United States ,Alcoholism ,Psychiatry and Mental health ,Cohort ,Female ,business ,030217 neurology & neurosurgery - Abstract
BackgroundThe purpose of this study was to assess the associations of comorbid opioid use disorders and psychiatric disorders with suicide attempts among veterans seeking pain care.MethodsThe cohort (N= 226 444) was selected by identifying pain care initiation from 2012 to 2014 using national Veterans Health Administration (VHA) data. Data on opioid use disorders (OUD), psychiatric disorders, medical comorbidity, demographics at baseline, and suicide attempts in the year following the initiation of pain care were extracted from VHA databases. Relative excess risk due to interaction (RERI) was used to assess departure from additivity of effects.ResultsAdjusted models indicated that both comorbid OUD and depression (RERI = 1.07) and comorbid OUD and AUD (RERI = 1.23) were significantly associated with additive risk of suicide attempt. In adjusted multiplicative interaction models, only comorbid OUD and bipolar disorder was significantly associated with suicide attempts; however, this association was protective (HR = 0.54).ConclusionsThe current findings highlight the importance of addressing opioid use disorders and alcohol use disorders and depression together to mitigate the risk of suicidal behavior.
- Published
- 2019