Shared correlates of prescription drug misuse and severe suicide ideation among clinical patients at risk for suicide.

Objective: Unintentional drug overdose and suicide have emerged as public health
problems. Prescription drug misuse can elevate risk of overdose. Severe suicidal ideation increases risk of suicide. We identified shared correlates of both risk factors to
inform cross-cutting prevention efforts.
Methods: We conducted a cross-sectional study using the Military Suicide Research
Consortium’s Common Data Elements survey; 2012–2017 baseline data collected
from 10 research sites were analyzed. The sample included 3962 clinical patients at
risk of suicide. Factors examined in relation to the outcomes, prescription drug misuse
and severe suicidal ideation, included demographic characteristics and symptoms of:
hopelessness; anxiety; post-traumatic stress disorder; alcohol use; other substance use;
prior head/neck injury; insomnia; and belongingness. Poisson regression models with
robust estimates provided adjusted prevalence ratios (aPRs) and 97.5% confidence
intervals (CIs).
Results: Medium and high (vs. low) levels of insomnia were positively associated
with prescription drug misuse (aPRs p < 0.025). Medium (vs. low) level of insomnia
was positively associated with severe suicidal ideation (aPR: 1.09; CI: 1.01–1.18).
Medium and high (vs. low) levels of perceived belongingness were inversely associated with both outcomes (aPRs p < 0.025).
Conclusions: Research should evaluate whether addressing sleep problems and improving belongingness can reduce prescription drug misuse and suicidal ideation
simultaneously.