Prevalence and correlates of suicide attempts in high-risk populations: a cross-sectional study among patients receiving opioid agonist therapy in Norway

Abstract

Background Death by suicide in patients enrolled in opioid agonist therapy (OAT) is a major clinical concern. However, little knowledge exists regarding suicide attempts in this patient group. This study presents the lifetime prevalence of suicide attempts and the associations between suicide attempts and clinical and sociodemographic variables such as education, sex, early onset of substance use (< 13 years of age), substance use patterns, and injecting substance use among patients receiving OAT. Methods We used data from a cohort of OAT patients in Norway obtained from a health assessment of self-reported suicide attempts and sociodemographic and clinical factors. A total of 595 patients receiving OAT were assessed from 2016 to 2020. A binary logistic regression analysis was performed and reported with an unadjusted odds ratio and 95% confidence intervals (OR). The purpose of this assessment was to analyze associations between suicide attempts and substance use patterns as well as the injection of substances during the 30 days leading up to the health assessment. A negative binomial regression analysis with an incidence rate ratio and 95% confidence intervals (IRR) was performed to investigate sex, education, early onset of substance use, and the number of suicide attempts. Results Forty-one percent of the OAT patients had attempted to die by suicide at least once during their lifetime. An early onset of substance use was strongly associated with the suicide attempts (IRR: 1.7, 1.3–2.2). No significant association was found between suicide attempts and sex (IRR: 1.2, 0.9–1.6) or education (IRR: 0.6, 0.2–2.1). Likewise, no association was identified between suicide attempts and injecting substance use (OR: 0.9, 0.6–1.3), nor using alcohol (OR: 0.9, 0.7–1.3), amphetamines (OR: 1.0, 0.7–1.3), benzodiazepines (OR: 1.0, 0.7–1.4), cannabis (OR: 1.2, 0.9–1.7), cocaine (OR: 1.3, 0.6–3.0), or opioids (OR: 1.4, 0.9–2.0). Conclusion The lifetime prevalence of suicide attempts was alarmingly high in the OAT population. An early onset of substance use seemed to be an important risk factor for suicide attempts. There was a non-significant association to more current use of opioids among OAT patients with previous suicide attempts.

Prevalence of alcohol use, depressive and anxiety symptoms among patients of opioid agonist treatment programmes in Ukraine

“…Ukrainian data are consistent (although it is essential to mention the difference in data gathering methodology and time frame of prevalence) with those recently found across the globe. Thus, US adults with OUD self-reported past 12-month thoughts of killing oneself in 29.8% of cases in 2020 [47]; among OAT centers' participants interviewed in 2021 in Nepal, lifetime suicidality was observed in 26.0% of cases [48]; 41% of the OAT patients in Norway surveyed during 2016-2020 had attempted to die by suicide at least once during their lifetime [49].…”

Effect of integrated hepatitis C virus treatment on psychological distress in people with substance use disorders

“…In addition, more than half of people with SUD suffer from substantial mental health symptoms of psychological distress, like fearfulness, tension, worthlessness, sleeping problems, and hopelessness 3 . These symptoms have a significant impact on health-related quality of life and well-being 4 – 6 , where the prevalence is particularly associated with the utilization of benzodiazepines, opioids, and cannabis, as well as underlying mental and somatic disorders 4 , 7 – 9 . HCV infection by itself is also associated with certain extrahepatic events, such as neurological and psychiatric complications 1 .…”

“…It is estimated that up to 80% of patients receiving OAT or injecting substances have been infected with HCV, and up to 70% have at least one mental health disorder 12 – 14 . Challenges related to health and life situations, such as suicidal ideation, high fatigue levels, and unstable living conditions, may worsen psychological distress and impact HCV treatment adherence 5 , 6 . Some observational studies have suggested that HCV treatment may reduce mental health symptoms, but the studies are prone to confounding and biases limiting any causal interpretations 11 , 15 .…”