The following is a summary of “Opioid Prescribing and Suicide Risk in the United States,” published in the June 2023 issue of Psychiatry by Olfson, et al.

For a study, researchers sought to examine the associations between regional changes in opioid prescribing and suicide deaths, specifically total suicide deaths and suicide overdose deaths involving opioids, in the United States.

A panel analysis was conducted using US National IQVIA Longitudinal Prescription Database data and National Center for Health Statistics mortality data. The data were aggregated into commuting zones (N=886), covering various regions nationwide. Opioid prescription exposures were assessed based on different measures, including opioid prescriptions per capita, percentages of patients with any opioid prescription, high-dose prescriptions (≥120 mg of morphine equivalents), long-term prescriptions (≥60 consecutive days), and prescriptions from three or more prescribers. Linear regression models with year and commuting zone fixed effects were used to analyze the associations.

The study found significant positive associations between suicide deaths and opioid prescriptions per capita (β=0.045), having any opioid prescription (β=0.069), high-dose prescriptions (β=0.024), long-term prescriptions (β=0.028), and prescriptions from three or more prescribers (β=0.046). Each of the five opioid prescription metrics and opioid overdose fatalities by suicide was shown to have similar statistically significant relationships (0.029–0.042). However, among people aged 10 to 24 and 25 to 44, unintentional opioid-related deaths were adversely correlated with opioid prescriptions per capita, having any opioid prescription, and having three or more opioid prescribers.

The study’s results indicated that decreases in regional opioid prescriptions, including decreases in suicide overdose deaths involving opioids, were consistently associated with decreases in overall suicide deaths. Interestingly, some measures of opioid prescribing were negatively associated with unintentional overdose deaths involving opioids in younger age groups (10-24 years and 25-44 years). However, it was important to note that the analysis was conducted at the ecological level, and individual-level inferences should be made with caution.

Source: ajp.psychiatryonline.org/doi/10.1176/appi.ajp.22020102