Background: A growing body of research has determined numerous physiological and social issues associated with Opioid Abuse (OA). While there have been general population studies showing that OA leads to various behavioral outcomes, analysis with respect to specific subgroups is not often conducted. This study will use data from Emergency Department (ED) visits across California to examine associations between OA and Suicide Attempt (SAT) in different population demographics and promote specialized public health intervention.
Methods: We used the California State Emergency Department Database (SEDD) to obtain discharge information from 2011, the most recent data available. This dataset contains discharge information on all ED encounters that did not result in an admission to the same facility. SEDD includes uninsured patients along with those covered by Medicare, Medicaid, and private insurance. OA and SAT were identified by using the relevant ICD-9 codes.
Results: The study included 10,124,598 patients referred to EDs in California in 2011. The prevalence of OA was 0.4%. The prevalence of SAT among ED patients was 0.3% for non-Opioid Abusers and 4.9% for OA (OR=18.02, 95%CI: 17.16-18.91). In a multivariable analysis, SAT was directly associated with OA and the number of chronic diseases. It was more frequent among females, whites, and younger age groups (10-30). Association of SAT with OA was stronger in female patients compared to males.
Conclusion: OA is a strong risk factor for SAT. SAT prevention should target females, younger populations, and patients with chronic diseases. These characteristics are not modifiable and targeted psychosocial treatment to this population is required to decrease the risk of SAT. On the other hand, OA is a modifiable risk factor of SAT and its treatment may significantly decrease the risk of SAT, especially in female patients. Female gender is a risk factor of SAT by itself. Moreover, abusing opioids by females increases the risk of SAT more than males. Therefore, OA rehabilitation would have greater benefits for female Opioid abusers than for males in the context of suicide prevention.