Prevalence and Correlates of Suicidal Thoughts and Suicide Attempts in People Prescribed Pharmaceutical Opioids for Chronic Pain

Gabrielle Campbell, Raimondo Bruno, Shane Darke, Fiona Shand, Wayne Hall, Michael Farrell, Louisa Degenhardt

The main objectives of the paper were (1) to examine the prevalence of suicidality in a large community-based chronic pain sample taking prescribed opioids for chronic pain; and (2) to examine general and pain-specific factors that predict such ideation, and the transition from ideation to making a suicide attempt (ideation-to-action). Baseline data from the Pain and Opioids IN Treatment (POINT) study with a cohort of 1514 community-based people prescribed opioids for chronic non-cancer pain across Australia. Past 12 month suicidal ideation was reported by 36.5% of the cohort and 16.4% had made a lifetime suicide attempt (2.5% in the last 12 mo), after the onset of their pain condition. Suicidal ideation in the past 12 months was independently associated with a past suicide attempt (AOR 4.82, 95%CI 2.43-9.56) and past 12 month depression (AOR 4.07, 95%CI 1.88-8.78). Only a lower pain-self efficacy score was independently associated with past 12 month ideation-to-action (AOR 0.98, 95%CI0.88-0.99). Notably, only general suicide risk factors were associated with 12 month suicidal ideation; but for past-year ideation-to-action, pain specific factors also had independent associations. The study is one of the first to comprehensively examine general and pain-specific risk factors for suicidality in a large chronic pain sample in which suicidal ideation was common. A low pain self-efficacy score was the only factor independently associated past 12 month ideation-to-action.