February 09, 2022
1 minute read
Disclosures: Please see the study for relevant financial information from all authors.
According to a study of Swedish data published in Pediatrics.
“Suicide is the second leading cause of death among people aged 10 to 34,” the researchers wrote. “Suicide by opioid overdose in particular is on the rise. Its contribution to suicide mortality in the United States doubled from 1999 to 2014, adding to broader concerns about the adverse effects of prescription opioids.
“Pain and its management with opioids is common among young people. There is therefore a clear need to understand the potential contribution of opioid prescribing to the risk of suicidal behavior in youth.
The authors analyzed Swedish population register data on nearly 1.9 million people aged 9 to 29 with no previously recorded opioid prescriptions. They identified prescriptions issued from January 2007 and diagnosed self-injurious behavior and one suicide death through December 2013. Ultimately, 201,433 members of the cohort initiated opioid prescriptions.
They found that opioid initiators had more than twice the risk of incident suicidal behavior (HR=2.64; 95% CI, 2.47-2.81), although in the active comparator design -” which examined suicidal behavior in opioid initiators compared to NSAID initiators while inverse-weighting the likelihood of treatment with individual and family covariates”- opioid initiators had a relatively higher risk of suicidal behavior of 19% compared to initiators of NSAIDs (HR=1.19; 95% CI, 1.11-1.28).This corresponded to a weighted cumulative incidence over 5 years of 2.2% (CI 95% CI, 2.1-2.4) for opioids and 1.9% (95% CI, 1.9-2.0) for initiators of NSAIDs.
“Opioid initiation may make only a small contribution to the elevated risk of suicidal behavior in youth receiving pharmacological pain treatment,” they wrote. “Weighing the benefits and harms of opioid initiation, our results suggest that the increased risk of suicidal behavior may not be a major concern.”