Pain, Substance use Disorders and Suicide: Risk Assessment and Mitigation

Death by suicide has become a global epidemic. Certain patient populations are at higher risk for suicidal ideation and suicidal behavior including patients that suffer from chronic pain and individuals with substance use disorders. Extant literature reveals that the prevalence of suicidal ideation in patients with chronic pain ranges from 20 to 50%. Another vulnerable population to death by suicide are patients with substance use disorders. Greater than 40 % of individuals presenting for treatment of a substance use disorder endorse a past history of attempting suicide. Patients with pain and co-occurring substance use disorders maybe be at high risk for attempting and ending their lives by suicide, but there is scant literature on the prevalence and unique risk factors for this patient population.

This presentation will discuss the results of a series of studies that evaluated the risk of suicidal ideation and identified risk factors of suicidal ideation in a cohort of patients with chronic pain on opioid therapy with no evidence of opioid use disorder and patients with chronic pain and concomitant opioid use disorders.  These results will be discussed in the context of a theoretical model of suicide and provide practical mitigation strategies.