Suicide risk identification and mitigation in patients with chronic pain prescribed opioid medication

Managing suicidality in persons with chronic pain is a challenging clinical scenario with no treatment guidelines to inform clinical decision-making related to suicide risk mitigation. Applying appropriate risk mitigation strategies, such as opioid education and naloxone distribution, lethal means safety education, increased frequency of appointments, individualized opioid tapers, consideration of nonopioid pharmacotherapy, nonpharmacological treatment options, and addressing modifiable risk factors, can decrease suicide risk. Recommending a treatment plan for patients with chronic pain experiencing suicidality is explored through 3 patient cases.