Opioid use as a proximal risk factor for suicidal behavior in young adults

Introduction There is a concomitant rise in suicide rates with the prevalence of opioids involved in overdose deaths, especially among adolescents and young adults. However, there are limited studies on whether opioid use prospectively predicts suicidal behavior in youth. Methods Our sample included 183 psychiatric patients (18–30 years) admitted for a suicide attempt (SA), have current suicidal ideation (SI), and psychiatric controls without ideation or attempt (PC). Suicidal behavior was assessed using the Columbia Suicide Severity Rating Scale. We also recruited a healthy control group (HC; n = 40). Patients and controls were followed over a year. ANOVA, regression, and cox regression were used. Results Suicide attempt (β = 0.87, CI [0.1–1.6], p = 0.02) and SI [(β = 0.75, CI [0.03–1.5], p = 0.04) were significantly more likely than HCs to have used opioids in the past year at baseline. Opioid use was associated with increased anxiety symptoms (β = 0.75, CI [0.001–1.5], p = 0.05), PTSD symptoms (β = 3.90, CI [1.1–6.7], p = 0.01), and aggression (β = 0.02, CI [0.01–0.04], p = 0.02). Opioid use in the month prior to hospitalization predicted SA at 6 months (OR = 1.87, CI [1.06–3.31], p = 0.032). Conclusions Opioid use is a proximal predictor for SA. These findings may help clinicians better identify patients at risk for suicidal behavior, allowing for more personalized treatment approaches.