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Heinz MV, Lekkas D, Abreu V, Lee C, Marsch LA, Jacobson NC. Evaluating a mobile app's effects on depression and anxiety in medication-treated opioid use disorder. NPJ MENTAL HEALTH RESEARCH 2024; 3:43. [PMID: 39349617 PMCID: PMC11443057 DOI: 10.1038/s44184-024-00086-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 09/09/2024] [Indexed: 10/04/2024]
Abstract
Depression and anxiety frequently co-occur with opioid use disorder (OUD) yet are often overlooked in standard OUD treatments. This study evaluated the feasibility, acceptability, and preliminary effectiveness of a mobile application designed to address these symptoms in individuals receiving medications for OUD (MOUD). A randomized controlled trial recruited N = 63 adults with OUD who received MOUD and screened positive for moderate depression or generalized anxiety. Participants were randomized to an app-based digital intervention or treatment-as-usual for 4 weeks, and completed follow-ups at 4 and 8 weeks. Primary outcomes were self-reported severity measures for depression and generalized anxiety, and urine drug screens (UDS). Secondary outcomes included self-reported OUD severity, craving intensity, and digital biomarkers derived from passive smartphone sensors. The application was well-received (median app rating = 4/5 stars). The intervention group showed significant reductions in depressive and generalized anxiety symptoms post-intervention and at 8 weeks follow-up (d > 0.70), with large (d = 0.78) and moderate (d = 0.38) effect sizes, respectively, compared to controls. Both groups exhibited substantial decreases in self-reported severity of opioid use symptoms (d > 2.50). UDS suggested similar between-group adherence to MOUD, with a marginal decrease in opioid (MOP) use in the intervention group and increase in controls, yielding medium between group effect sizes (d = 0.44). Passive sensor data suggested significant increases in social connectedness in the intervention group, evidenced by a significant rise in incoming and outgoing calls and text connections. Initial evidence supports the feasibility and acceptability of a digital intervention for treating anxiety and depressive symptoms in persons receiving MOUD. While underpowered to confidently determine statistical significance beyond directionality, the intervention showed promise in reducing depressive and anxiety symptoms, suggesting its potential as a cost-effective and scalable adjunctive therapy alongside standard OUD treatment. Due to the preliminary nature of this pilot study, further research with sample sizes permitting greater statistical power is needed to confirm findings and explore long-term effects.
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Affiliation(s)
- Michael V Heinz
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA.
- Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA.
| | - Damien Lekkas
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
- Quantitative Biomedical Sciences Program, Dartmouth College, Hanover, NH, USA
| | - Veronica Abreu
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
| | - Camilla Lee
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
| | - Lisa A Marsch
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
- Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
- Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
| | - Nicholas C Jacobson
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
- Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
- Quantitative Biomedical Sciences Program, Dartmouth College, Hanover, NH, USA
- Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
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Gallant KC, Harris BR. Community Collaboration for Suicide and Overdose Prevention: Attitudes, Perceptions, and Practices of Community-Based Professionals and County Leadership in New York State. Community Ment Health J 2024; 60:859-868. [PMID: 38374308 DOI: 10.1007/s10597-024-01238-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 01/10/2024] [Indexed: 02/21/2024]
Abstract
Deaths by overdose and suicide have been steadily rising, yet efforts to jointly address them have been limited despite shared risk and protective factors. The purpose of this study was to explore ways of jointly addressing these two significant public health issues at the community level. To accomplish this goal, we distributed an electronic survey via email to all 58 Local Mental Hygiene Directors (LMHDs) and 184 substance use and 57 suicide prevention coalition leads in New York State in March 2019 to better understand attitudes, perceptions, and practice of community-based overdose and suicide prevention. A total of 140 unique individuals completed the survey for a 47% usable response rate. Participants overwhelmingly reported that suicide and overdose are preventable and that individuals with risky substance use would benefit most from suicide prevention services compared to other populations. In addition, substance use prevention coalition leads reported less awareness of key suicide prevention programs than suicide prevention coalition leads and LMHDs; LMHDs were generally most familiar with suicide prevention programs. Finally, substance use and suicide prevention coalition leads were interested in collaborating to raise awareness, provide training, and implement community-based activities. These findings demonstrate a consensus among county leadership and substance use and suicide prevention coalition leads that suicide and overdose are prevalent in their communities and that increased collaboration to address these two public health issues is warranted. Results suggest a need for education, training, and technical assistance to support collaboration.
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Affiliation(s)
- Katharine C Gallant
- Public Health Research Department, NORC at the University of Chicago, Bethesda, MD, USA.
| | - Brett R Harris
- Public Health Research Department, NORC at the University of Chicago, Bethesda, MD, USA
- Department of Health Policy, Management, and Behavior, University at Albany School of Public Health, Rensselaer, NY, USA
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Pinchman EV, Lende MN, Feustel P, Lynch T. Evaluating the Association between Prenatal Care Visits and Adverse Perinatal Outcome in Pregnancies Complicated by Opioid Use Disorder. Am J Perinatol 2024; 41:e2225-e2229. [PMID: 37286184 DOI: 10.1055/a-2107-1834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE This study aimed to evaluate the association between number of prenatal care visits and adverse perinatal outcome among pregnant individuals with opioid use disorder (OUD). STUDY DESIGN This is a retrospective cohort of singleton, nonanomalous pregnancies complicated by OUD that delivered from January 2015 to July 2020 at our academic medical center. Primary outcome was the presence of composite adverse perinatal outcome, defined as one or more of the following: stillbirth, placental abruption, perinatal death, neonatal respiratory distress syndrome, need for morphine treatment, and hyperbilirubinemia. Logistic and linear regression estimated the association between the number of prenatal care visits and the presence of adverse perinatal outcome. A Mann-Whitney U test evaluated the association between number of prenatal care visits and length of hospital stay for the neonate. RESULTS A total of 185 patients were identified, of which 35 neonates required morphine treatment for neonatal opioid withdrawal syndrome. During pregnancy, most individuals were treated with buprenorphine 107 (57.8%), whereas 64 (34.6%) received methadone, 13 (7.0%) received no treatment, and 1 (0.5%) received naltrexone. The median number of prenatal care visits was 8 (interquartile range: 4-10). With each additional visit per 10 weeks of gestational age, the risk of adverse perinatal outcome decreased by 38% (95% confidence interval [CI]: 0.451-0.854). The need for neonatal intensive care and hyperbilirubinemia also significantly decreased with additional prenatal visits. Neonatal hospital stay decreased by a median of 2 days (95% CI: 1-4) for individuals who received more than the median of eight prenatal care visits. CONCLUSION Pregnant individuals with OUD who attend fewer prenatal care visits experience more adverse perinatal outcome. Future research should focus on barriers to prenatal care and interventions to improve access in this high-risk population. KEY POINTS · Use of prenatal care affects newborn outcomes.. · More prenatal care shortens neonatal hospital stay.. · Prenatal care reduces certain adverse outcomes..
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Affiliation(s)
| | - Michelle N Lende
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Albany Medical Center, Albany, New York
| | - Paul Feustel
- Department of Neuroscience, Albany Medical College, Albany, New York
| | - Tara Lynch
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Albany Medical Center, Albany, New York
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Pavarin RM, Lia L, Tugnoli S, Caracciolo S. Suicide Attempts in an Italian Population with Cannabis Use Disorders: Results of a Follow-Up Study. J Psychoactive Drugs 2023:1-8. [PMID: 38009854 DOI: 10.1080/02791072.2023.2287674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 10/23/2023] [Indexed: 11/29/2023]
Abstract
The relationship between cannabis use and suicidal behavior is complex, with no consensus in the literature. We used electronic health records of national health services to identify individuals who received a diagnosis of Cannabis Use Disorder in the Metropolitan area of Bologna from 2009 to 2019. In this cohort we identified accesses to Emergency Departments for suicide attempts from 2009 to 2019. The Crude Suicide Rate for 1,000 Person Years was 2.5, higher in females, in patients with Alcohol Use Disorders, with any psychiatric diagnosis, within one year from the first visit, and during the COVID-19 period. The risk was over 22 times higher than in the general population. Considering the high prevalence of cannabis use in the general population and the consequent risk of Cannabis Use Disorders, these data suggest the importance of a clinical evaluation for suicidal risk.
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Affiliation(s)
- Raimondo Maria Pavarin
- Epidemiological Monitoring Center on Addiction, Department of Mental Health and Pathological Addictions, Italian Society of Substance Abuse (SITD), Local Health Unit of Bologna, Bologna, Italy
| | - Loredana Lia
- Mental Health DSM-DP, Azienda USL Bologna, Bologna, Italy
| | - Stefano Tugnoli
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Stefano Caracciolo
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
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Aloi MS, Poblete GF, Oldham J, Patriquin MA, Nielsen DA, Kosten TR, Salas R. miR-124-3p target genes identify globus pallidus role in suicide ideation recovery in borderline personality disorder. NPJ MENTAL HEALTH RESEARCH 2023; 2:8. [PMID: 37712050 PMCID: PMC10500603 DOI: 10.1038/s44184-023-00027-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 04/11/2023] [Indexed: 09/16/2023]
Abstract
Borderline personality disorder (BPD) is characterized by patterns of unstable affect, unstable interpersonal relationships, and chronic suicidal tendencies. Research on the genetics, epigenetics, and brain function of BPD is lacking. MicroRNA-124-3p (miR-124-3p) was recently identified in a Genome-Wide Association Study as likely associated with BPD. Here, we identified the anatomical brain expression of genes likely modulated by miR-124-3p and compared morphometry in those brain regions in BPD inpatients vs. controls matched for psychiatric comorbidities. We isolated lists of targets likely modulated by miR-124-3p from TargetScan (v 8.0) by their preferentially conserved targeting (Aggregate PCT > 0.99, see Supplementary Table 1). We applied Process Genes List (PGL) to identify regions of interest associated with the co-expression of miR-124-3p target genes. We compared the gray matter volume of the top region of interest co-expressing those genes between BPD inpatients (n = 111, 46% female) and psychiatric controls (n = 111, 54% female) at The Menninger Clinic in Houston, Texas. We then correlated personality measures, suicidal ideation intensity, and recovery from suicidal ideation with volumetrics. Gene targets of miR-124-3p were significantly co-expressed in the left Globus Pallidus (GP), which was smaller in BPD than in psychiatric controls. Smaller GP volume was negatively correlated with agreeableness and with recovery from suicidal ideation post-treatment. In BPD, GP volume may be reduced through miR-124-3p regulation and suppression of its target genes. Importantly, we identified that a reduction of the GP in BPD could serve as a potential biomarker for recovery from suicidal ideation.
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Affiliation(s)
- Macarena S. Aloi
- Menninger Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA
- These authors contributed equally: Macarena S. Aloi, Guillermo F. Poblete
| | - Guillermo F. Poblete
- The Menninger Clinic, Baylor College of Medicine, Houston, TX, USA
- These authors contributed equally: Macarena S. Aloi, Guillermo F. Poblete
| | - John Oldham
- Menninger Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA
- The Menninger Clinic, Baylor College of Medicine, Houston, TX, USA
| | - Michelle A. Patriquin
- Menninger Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA
- The Menninger Clinic, Baylor College of Medicine, Houston, TX, USA
- Michael E DeBakey VA Medical Center, Houston, TX, USA
| | - David A. Nielsen
- Menninger Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA
- Michael E DeBakey VA Medical Center, Houston, TX, USA
| | - Thomas R. Kosten
- Menninger Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA
- Michael E DeBakey VA Medical Center, Houston, TX, USA
- Department of Neuroscience, Baylor College of Medicine, Houston, TX, USA
| | - Ramiro Salas
- Menninger Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA
- The Menninger Clinic, Baylor College of Medicine, Houston, TX, USA
- Michael E DeBakey VA Medical Center, Houston, TX, USA
- Department of Neuroscience, Baylor College of Medicine, Houston, TX, USA
- Center for Translational Research on Inflammatory Diseases, Michael E DeBakey VA Medical Center, Houston, TX, USA
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Sherry TB, Nguyen T, Dick AW, Bradford AC, Simon K, Stein BD. A National Retrospective Study of Antidepressants' Effects on Overdose and Self-Harm Among Adults Treated With Opioid Analgesics. Psychiatr Serv 2023; 74:24-30. [PMID: 35770423 PMCID: PMC10654712 DOI: 10.1176/appi.ps.20220070] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Because individuals with a history of depression who are receiving opioids are at higher risk for adverse events, the authors examined whether antidepressant treatment reduces risk for overdose and self-harm among individuals with a history of depression who receive opioids. METHODS Commercial insurance claims of individuals with a history of depression receiving opioids from 2007 to 2017 were used to quantify the association between antidepressant fills and adverse events among individuals after initiation of opioid treatment; the authors accounted for selection into treatment and used discrete-time, proportional hazards survival models. RESULTS Among 283,374 adults with a history of depression treatment, 8,203 experienced 47,486 adverse events from 2007 to 2017 in the 12 months after initiation of opioid treatment. Approximately half (N=144,052, 50.8%) filled an antidepressant prescription at least once in the 12 months after the opioid episode began. Individuals receiving antidepressants for at least 6 weeks had a reduced risk for any adverse event (adjusted odds ratio [AOR]=0.79, 95% confidence interval [CI]=0.65-0.97) as well as a reduced risk for opioid overdoses (AOR=0.78, 95% CI=0.64-0.96), overdoses from nonopioid controlled substances (AOR=0.76, 95% CI=0.62-0.94), overdoses from other substances (AOR=0.79, 95% CI=0.65-0.97), and other self-harm events (AOR=0.82, 95% CI=0.67-1.00). CONCLUSIONS Individuals with a history of depression who received opioid analgesics had a significantly lower risk for overdose and self-harm after they had been taking antidepressants for at least 6 weeks. Universal screening for mood disorders among individuals receiving opioids, and promptly providing evidence-based depression treatment when appropriate, may reduce adverse events.
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Affiliation(s)
- Tisamarie B Sherry
- RAND Corporation, Arlington, Virginia (Sherry), Boston (Dick), and Pittsburgh (Stein); Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor (Nguyen); O'Neill School of Public and Environmental Affairs, Indiana University, Bloomington (Bradford, Simon)
| | - Thuy Nguyen
- RAND Corporation, Arlington, Virginia (Sherry), Boston (Dick), and Pittsburgh (Stein); Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor (Nguyen); O'Neill School of Public and Environmental Affairs, Indiana University, Bloomington (Bradford, Simon)
| | - Andrew W Dick
- RAND Corporation, Arlington, Virginia (Sherry), Boston (Dick), and Pittsburgh (Stein); Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor (Nguyen); O'Neill School of Public and Environmental Affairs, Indiana University, Bloomington (Bradford, Simon)
| | - Ashley C Bradford
- RAND Corporation, Arlington, Virginia (Sherry), Boston (Dick), and Pittsburgh (Stein); Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor (Nguyen); O'Neill School of Public and Environmental Affairs, Indiana University, Bloomington (Bradford, Simon)
| | - Kosali Simon
- RAND Corporation, Arlington, Virginia (Sherry), Boston (Dick), and Pittsburgh (Stein); Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor (Nguyen); O'Neill School of Public and Environmental Affairs, Indiana University, Bloomington (Bradford, Simon)
| | - Bradley D Stein
- RAND Corporation, Arlington, Virginia (Sherry), Boston (Dick), and Pittsburgh (Stein); Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor (Nguyen); O'Neill School of Public and Environmental Affairs, Indiana University, Bloomington (Bradford, Simon)
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Grove JL, April LY, Evan MK. Social Support as Protective Factor for Suicidal Ideation during Treatment for Substance Abuse: Differential Effects across Treatment Modalities. CURRENT RESEARCH IN BEHAVIORAL SCIENCES 2022. [DOI: 10.1016/j.crbeha.2022.100087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Frost MC, Richards JE, Blosnich JR, Hawkins EJ, Tsui JI, Edelman EJ, Williams EC. Association between clinically recognized suicidality and subsequent initiation or continuation of medications for opioid use disorder. Drug Alcohol Depend 2022; 237:109521. [PMID: 35716644 PMCID: PMC9546132 DOI: 10.1016/j.drugalcdep.2022.109521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 05/09/2022] [Accepted: 05/28/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Among individuals with opioid use disorder (OUD), medications for OUD (MOUD) may lower suicide risk. Therefore, it is important that individuals with OUD and suicidality receive MOUD. This study examined associations between clinically recognized suicidality and subsequent initiation or continuation of MOUD among patients with OUD in the national Veterans Health Administration (VA). METHODS Electronic health record data were extracted for outpatients with OUD who received VA care 10/1/2016-7/31/2017. Suicidality was measured using diagnostic codes for suicidal ideation/attempt and patient record flags. Analyses were conducted separately among patients without prior-year MOUD receipt to examine MOUD initiation, and with prior-year MOUD receipt to examine MOUD continuation. Poisson regression models estimated likelihood of MOUD receipt in the following year for patients with prior-year suicidality relative to those without. Models were adjusted for sociodemographic and clinical characteristics. RESULTS Among 20,085 patients with no prior-year MOUD, 12% had suicidality and 12% received MOUD in the following year. Suicidality was positively associated with MOUD initiation (adjusted incidence rate ratio [aIRR]: 1.15, 95% confidence interval [CI]: 1.04-1.28). Among 10,162 patients with prior-year MOUD, 9% had suicidality and 84% received MOUD in the following year. Suicidality was negatively associated with MOUD continuation (aIRR: 0.95, 95% CI 0.91-0.98). CONCLUSIONS Among VA patients with OUD, clinically recognized suicidality may increase likelihood of MOUD initiation but decrease likelihood of continuation. Efforts to increase initiation overall and to support retention for patients with suicidality are needed.
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Affiliation(s)
- Madeline C Frost
- Health Services Research & Development (HSR&D) Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs (VA) Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA 98108, USA; Department of Health Systems and Population Health, University of Washington School of Public Health, 1959 NE Pacific St, Seattle, WA 98195, USA.
| | - Julie E Richards
- Department of Health Systems and Population Health, University of Washington School of Public Health, 1959 NE Pacific St, Seattle, WA 98195, USA; Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Seattle, WA 98101, USA.
| | - John R Blosnich
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 669W 34th St, Los Angeles, CA 90089, USA; Health Services Research & Development (HSR&D) Center for Health Equity Research and Promotion, Veterans Affairs (VA) Pittsburgh Healthcare System, University Drive (151C), Pittsburgh, PA 15240, USA.
| | - Eric J Hawkins
- Health Services Research & Development (HSR&D) Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs (VA) Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA 98108, USA; Center of Excellence in Substance Addiction Treatment and Education, Veterans Affairs (VA) Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA 98108, USA; Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, 1959 NE Pacific St, Seattle, WA 98195, USA.
| | - Judith I Tsui
- Department of Medicine, University of Washington School of Medicine, 1959 NE Pacific St, Seattle, WA 98195, USA.
| | - E Jennifer Edelman
- Department of Internal Medicine, Yale School of Medicine, 333 Cedar St, New Haven, CT 06510, USA.
| | - Emily C Williams
- Health Services Research & Development (HSR&D) Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs (VA) Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA 98108, USA; Department of Health Systems and Population Health, University of Washington School of Public Health, 1959 NE Pacific St, Seattle, WA 98195, USA.
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Suicide Attempts in an Italian Population with Substance Use Disorders: Results of a Follow-up Study. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00855-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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10
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Chesin MS, Dave CV, Myers C, Stanley B, Kline A, Monahan M, Latorre M, Hill LMS, Miller RB, King AR, Boschulte DR, Sedita M, Interian A. Using Mindfulness-Based Cognitive Therapy to Prevent Suicide Among High Suicide–Risk Patients Who Also Misuse Opioids: a Preliminary Probe of Feasibility and Effectiveness. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00817-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Streck JM, Parker MA, Bearnot B, Kalagher K, Sigmon SC, Goodwin RD, Weinberger AH. National Trends in Suicide Thoughts and Behavior among US Adults with Opioid Use Disorder from 2015 to 2020. Subst Use Misuse 2022; 57:876-885. [PMID: 35232317 PMCID: PMC9084338 DOI: 10.1080/10826084.2022.2046102] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Suicide thoughts and behavior (STB) are associated with premature mortality and is disproportionately represented among those with opioid use disorder (OUD). Recent trends in STB among those with OUD are lacking. We investigated trends in STB among US adults with versus without OUD using six waves of cross-sectional, nationally-representative, epidemiological data. METHODS Data came from the 2015-2020 National Survey on Drug Use and Health (combined n = 241,675). We compared past-year STB outcomes (i.e., thoughts of seriously considering killing self (SI), suicide plan (SP), suicide attempt (SA)) among adults with versus without past-year OUD. Unadjusted and adjusted logistic regression tested the association between survey-year and past-year STB outcomes (i.e., SI, SP/SA) stratified by OUD status. RESULTS Between 2015 and 2020, 26% versus 4% of those with and without OUD, respectively, reported SI, 10% versus 1% reported a SP, and 6% versus 1% reported SA (all ps < 0.001). In adjusted analyses, across survey years, no changes in the prevalence of SI were observed for adults with or without OUD, and no changes were observed over time for SP/SA in adults with or without OUD. OUD severity and treatment status did not moderate the relationship between OUD and STB outcomes. CONCLUSIONS Among US adults, OUD was associated with thoughts of suicide and suicide behavior. The heightened prevalence of STB in adults with OUD has not changed in recent years. Screening for SI is needed among those reporting opioid misuse and should be routinely integrated into OUD prevention and treatment.
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Affiliation(s)
- Joanna M Streck
- Tobacco Research and Treatment Center, Division of General Internal Medicine (DGIM), Department of Medicine, Massachusetts General Hospital (MGH)/Harvard Medical School (HMS), Boston, Massachusetts, USA.,Department of Psychiatry, MGH/HMS, Boston, Massachusetts, USA
| | - Maria A Parker
- Department of Epidemiology & Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington, Indiana, USA
| | - Benjamin Bearnot
- Tobacco Research and Treatment Center, Division of General Internal Medicine (DGIM), Department of Medicine, Massachusetts General Hospital (MGH)/Harvard Medical School (HMS), Boston, Massachusetts, USA
| | - Kelly Kalagher
- Tobacco Research and Treatment Center, Division of General Internal Medicine (DGIM), Department of Medicine, Massachusetts General Hospital (MGH)/Harvard Medical School (HMS), Boston, Massachusetts, USA
| | - Stacey C Sigmon
- Department of Psychiatry, Vermont Center on Behavior & Health, University of Vermont, Burlington, Vermont, USA
| | - Renee D Goodwin
- Mailman School of Public Health, Columbia University, New York, New York, USA.,Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, New York, USA
| | - Andrea H Weinberger
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA.,Albert Einstein College of Medicine, Bronx, New York, USA
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