Past studies found that motivation for suicide may contribute to opioid overdose deaths in people with opioid use disorder (OUD).
In 2019, a research team at McLean Hospital found suicidal motivations are common just prior to nonfatal opioid overdose and occur along a continuum of severity.
希拉里年代. 康纳利博士，医学博士临床主任 McLean’s Division of Alcohol, Drugs, and 上瘾, R. 凯瑟琳·麦克休博士, McLean’s chief of psychology and director of the Stress, 焦虑, and Substance Use Laboratory, and colleagues recently replicated and extended those findings in a study published in 药物和酒精依赖.
方法
The study setting was an inpatient unit at McLean for managing withdrawal from substance use.
Between June 2017 and March 2020, the researchers identified 60 adults who reported a history of opioid overdose and consented to complete self-report measures about their history of opioid use and overdoses, beliefs about the likelihood of overdose, and thoughts about death from overdose.
The mean number of overdoses was 4.5. The most recent overdose occurred within the past year for 48% of patients and within the past month for 20%.
结果
Participant ratings of 渴望死亡 and intention to die suggested that these are dimensional factors, 不是二元因素, with the full range from none to high represented:
Question: “Just before your most recent overdose, how likely did you think it was that you would overdose?”
- No chance (rating of 0 on a 0-10 scale)—39% of participants
- High likelihood (rating ≥7)—14%
- 意味着等级2.4
Question: “Just before your most recent opioid overdose, how strongly did you want to die?”
- Did not want to die (rating of 0 on a 0-10 scale)—54%
- Some 渴望死亡 (rating ≥1)—46%
- Strong 渴望死亡 (rating ≥7)—19%
- 意味着等级2.7
Question: “At the time of your most recent overdose, were you trying to kill yourself?”
- No intention (rating of 0 on a 0-10 scale)—80.4%
- Mild intention (rating of 1-3)—8.9%
- Moderate intention (rating of 4-6)—5.3%
- Strong intention (rating >7)—5.3%
- 意味着rating-0.9
14 of 34 participants who perceived some risk of overdose reported neither intent nor 渴望死亡.
相关性
相关性 between the three factors (perceived likelihood of overdose, 渴望死亡, and intention to die) were in the range of a medium effect size.
Reports of intention to die and 渴望死亡 were not redundant, suggesting that solely assessing intention to die is insufficient to detect potentially clinically relevant suicidal thinking.
病人 With OUD Need Interventions for 预防自杀
To amplify efforts to reduce fatal and nonfatal opioid overdoses, care for patients with OUD should include:
- Universal suicide prevention screening
- 预防自杀教育
- Personalized safety planning, including attention to underestimation of overdose risk
These measures may be particularly important for times of crisis, 例如COVID-19大流行, when emergency department visits surged for both suicide attempts and drug overdoses.
Looking for mental health care for someone struggling with substance addiction? 今天打电话给我们: 877.322.2749 to 转诊病人.
