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Opioid use disorders, psychiatric comorbidities, and risk for suicide attempts among veterans seeking pain care

Published online by Cambridge University Press:  16 September 2019

Lisham Ashrafioun ,
Kotwoallama R. A. Zerbo ,
Todd M. Bishop  and
Peter C. Britton
Lisham Ashrafioun*
Affiliation:
Department of Veterans Affairs Center of Excellence for Suicide Prevention, VA Finger Lakes Healthcare System, 400 Fort Hill Avenue, Canandaigua, NY14424, USA Department of Psychiatry, University of Rochester School of Medicine & Dentistry, 300 Crittenden Boulevard, Rochester, NY14642, USA
Kotwoallama R. A. Zerbo
Affiliation:
Department of Veterans Affairs Center of Excellence for Suicide Prevention, VA Finger Lakes Healthcare System, 400 Fort Hill Avenue, Canandaigua, NY14424, USA
Todd M. Bishop
Affiliation:
Department of Veterans Affairs Center of Excellence for Suicide Prevention, VA Finger Lakes Healthcare System, 400 Fort Hill Avenue, Canandaigua, NY14424, USA Department of Psychiatry, University of Rochester School of Medicine & Dentistry, 300 Crittenden Boulevard, Rochester, NY14642, USA
Peter C. Britton
Affiliation:
Department of Veterans Affairs Center of Excellence for Suicide Prevention, VA Finger Lakes Healthcare System, 400 Fort Hill Avenue, Canandaigua, NY14424, USA Department of Psychiatry, University of Rochester School of Medicine & Dentistry, 300 Crittenden Boulevard, Rochester, NY14642, USA
*
Author for correspondence: Lisham Ashrafioun, E-mail: Lisham.Ashrafioun@va.gov
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Abstract

Background

The 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.

Methods

The 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.

Results

Adjusted 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).

Conclusions

The current findings highlight the importance of addressing opioid use disorders and alcohol use disorders and depression together to mitigate the risk of suicidal behavior.

Keywords

Comorbiditypainpsychiatric disorderssuicide attemptveterans
Type
Original Articles
Information
Psychological Medicine , Volume 50 , Issue 12 , September 2020 , pp. 2107 - 2112
Copyright
Copyright © Cambridge University Press 2019

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