Fewer SUICIDES… more “deaths of despair” ?

Posted on December 18, 2019 by Pharmaciststeve

There are fewer suicides related to opioids than previously believed, research says

https://www.cnn.com/2019/12/17/health/opioid-overdose-death-suicide-study/index.html

Since 1999, significant increases in US suicide rates have paralleled increases in drug overdoses from opioids. Experts have wondered how much the two might be intertwined, estimating that the

percent of suicides among opioid overdose deaths to be as high as 20% to 30%.

But a new analysis of numbers finds that the link between opioids and suicide might be much smaller than initially believed.
US life expectancy is still on the decline. Here’s why
The percent of opioid-related suicides actually fell in recent years, dropping from 9% in 2000 to 4% in 2017, according to a research letter published Tuesday in the medical journal JAMA.
“It gives you a very different picture of the role of opioids in the suicide epidemic,” said Dr. Mark Olfson, lead author of the analysis and a professor of psychiatry at Columbia University Medical Center.
The conversation around “deaths of despair” — deaths related to suicide, drug overdose, liver disease and cirrhosis — has taken on a specific narrative, Olfson said, intertwining the opioid epidemic and suicide.

Deaths of despair

The phrase “deaths of despair” was coined by the Princeton-based economists Sir Angus Deaton and Anne Case. They were among the first to note these deaths have increased significantly in the United States since the 1990s, particularly among white males.

Increases in these “deaths of despair” have been so significant in recent years, that they are major drivers in reducing American life expectancy.

Deaton and Case noted that while the supply of opioids increased since 1999, it’s not the “fundamental factor” behind increased mortality, but rather, the prescription of opioids for chronic pain “added fuel to the flames” of overall mortality.
A report issued in September from the US Congress Joint Economic Committee titled “Long-Term Trends in Deaths of Despair” noted, “Mortality from deaths of despair far surpasses anything seen in America since the dawn of the 20th century. …The recent increase has primarily been driven by an unprecedented epidemic of drug overdoses.”

Opioids and suicide not as closely tied as believed

“There’s been a tendency as seeing opioid overdose and suicide as this one thing,” said Olfson, “but when you look at the deaths, they aren’t tied as strongly as we had imagined. “
Asking for help

The suicide rate in the United States has seen sharp increases in recent years. Studies have shown that the risk of suicide declines sharply when people call the national suicide hotline: 1-800-273-TALK.

There is also a crisis text line. For crisis support in Spanish, call 1-888-628-9454.

The lines are staffed by a mix of paid professionals and unpaid volunteers trained in crisis and suicide intervention. The confidential environment, the 24-hour accessibility, a caller’s ability to hang up at any time and the person-centered care have helped its success, advocates say.

Olfson and his colleagues analyzed mortality data from the National Vital Statistics System from 2000 to 2017, looking specifically at unintentional or accidental deaths, suicides and deaths of undetermined cause, and tallying those associated with opioids.

The proportion of opioid-related deaths related to suicide dropped from from 9% in 2000 to 4% in 2017. But, despite that decrease, researchers noted that between 2000 and 2017, the rate of opioid-related suicides actually increased in that same time frame. In 2000, there were 0.27 opioid-related suicides per 100,000 people. In 2017, that rate increased to 0.58 opioid-related suicides per 100,000 people.
Increases in opioid-related suicide rates were observed for males, females, all racial and ethnic groups, as well as all age groups — except for those between the ages of 35 and 44.

The emergence of fentanyl

Olfson believes the introduction of lethal and illicit fentanyl is a factor driving the drop in proportion of opioid-related suicides, even as the rate increased.
US drug overdose deaths fell slightly in 2018
Fentanyl is a synthetic opioid that can be up to 50 times as potent as heroin. Overall fatal drug overdoses related to fentanyl skyrocketed more than 1,000% between 2011 and 2016. There were 70,237 fatal drug overdoses in 2017 and about 40% of them involved synthetic drugs such as fentanyl.
When looking at overall opioid-related deaths, the proportion of people accidentally dying from opioid overdose has increased significantly because of the power of fentanyl.
“It has it has contributed to a larger share of the deaths being accidental. So, in a way, it’s sort of crowding out the intentional deaths,” Olfson said.
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But Olfson was careful to note that this didn’t mean that researcher and health care providers shouldn’t be concerned about opioids and suicide.
“You can’t take your eye off of this — it just changes the view and our understanding,” he said.

To get help, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). There is also a crisis text line. For crisis support in Spanish, call 1-888-628-9454.

Filed under: General Problems

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3 Responses

  1. F1 Rocket Engine, on December 18, 2019 at 6:52 pm said:

    Suicide with a prescription opiate ALONE is rare because the doses are small. Our Dr. K said it is difficult to kill yourself even with a whole bottle of oxy ALONE, These just sleep. It would have to be mixed with alcohol or another depressant unless they had a very low resistance.

    Reply
  2. iamfbch, on December 18, 2019 at 6:16 pm said:

    Well I read this..I think maybe I went stupid over night. I had to keep reading this over a few times to try and understand the gibberish. Now they are saying if you OD on an opioid you committed suicide? i guess I went stupid. Or this is written in “code” for a select few

    Reply
  3. iamfbch, on December 18, 2019 at 5:19 pm said:

    I have to admit I saw red when I saw headline of this topic. Even if its ONE LIFE,its one to many!! What a dumb ass thing to report.Do the idiots involved with this feel good about this? I’ll stop now and try to calm down and read this..My rant isnt directed at you Steve

    Reply

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