In the Journals

Prescription opioid, benzodiazepine misuse tied to suicidal thoughts in older adults

Study data revealed a connection between pastyear prescription opioid and benzodiazepine misuse and pastyear suicidal ideation in adults aged 50 years and older in the United States.

“Older adults have a heightened potential for accidental overdose and appear to have more lethal suicide attempts than those of younger individuals,” Ty S. Schepis, PhD, from the department of psychology at Texas State University, and colleagues wrote. “[Prior] evidence suggests that research is needed evaluating potential links between opioid and benzodiazepine [prescription drug misuse] in older adults and suicidal ideation; work also is needed that evaluates potential links between use (without misuse) of these medications and suicidal ideation.”

To address this gap in research, Schepis and colleagues examined data from 17,608 adults aged 50 years and older participating in the 2015 to 2016 National Survey on Drug Use and Health. Using designbased logistic regression, they assessed the connections between any pastyear prescription opioid or benzodiazepine use without misuse or prescription misuse and pastyear suicidal ideation. Analysis also controlled for sociodemographic, physical health, mental health and substance use correlates tied to suicidal ideation.

After adjustment, the analysis demonstrated that pastyear use without misuse of prescription opioids or benzodiazepines was not linked to pastyear suicidal ideation in older adults. However, pastyear opioid misuse (adjusted OR = 1.84; 95% CI, 1.073.19) and benzodiazepine misuse (aOR = 2; 95% CI, 1.013.94) were significantly linked to pastyear suicidal ideation.

Furthermore, pastyear alcohol use disorder, nicotine dependence, marijuana use, and marijuana use disorder were all tied to increased risk for pastyear suicidal ideation (all P < .001). The researchers also reported that 2.2% of older adults without either opioid or benzodiazepine misuse had pastyear suicidal ideation.

In addition, 25.4% of those who misused both medication classes endorsed past-year suicidal thoughts (aOR = 4.73; 95% CI, 2.0710.79), which was almost three times the prevalence of suicidal ideation in those with only opioid misuse (8.3%) or only benzodiazepine misuse (8.8%), according to the results.

“Together, these results suggest that older adults need to be screened for prescription opioid and/or benzodiazepine misuse and that those endorsing misuse or with signs of misuse (eg, early refill requests, inconsistent pill counts) also need to be screened for suicidal ideation,” Schepis and colleagues wrote.

“Use of prescription drug monitoring program databases is also encouraged to identify potential course of opioid and benzodiazepine medication in older adults,” they continued. “In addition to limiting the potential harms in older adults of prescription misuse, such screening could identify those atrisk for more frank suicidal behavior, limiting the consequences of [prescription drug misuse] and suicidality in older adults.” – by Savannah Demko

Disclosure: The authors report no relevant financial disclosures.

Study data revealed a connection between pastyear prescription opioid and benzodiazepine misuse and pastyear suicidal ideation in adults aged 50 years and older in the United States.

“Older adults have a heightened potential for accidental overdose and appear to have more lethal suicide attempts than those of younger individuals,” Ty S. Schepis, PhD, from the department of psychology at Texas State University, and colleagues wrote. “[Prior] evidence suggests that research is needed evaluating potential links between opioid and benzodiazepine [prescription drug misuse] in older adults and suicidal ideation; work also is needed that evaluates potential links between use (without misuse) of these medications and suicidal ideation.”

To address this gap in research, Schepis and colleagues examined data from 17,608 adults aged 50 years and older participating in the 2015 to 2016 National Survey on Drug Use and Health. Using designbased logistic regression, they assessed the connections between any pastyear prescription opioid or benzodiazepine use without misuse or prescription misuse and pastyear suicidal ideation. Analysis also controlled for sociodemographic, physical health, mental health and substance use correlates tied to suicidal ideation.

After adjustment, the analysis demonstrated that pastyear use without misuse of prescription opioids or benzodiazepines was not linked to pastyear suicidal ideation in older adults. However, pastyear opioid misuse (adjusted OR = 1.84; 95% CI, 1.073.19) and benzodiazepine misuse (aOR = 2; 95% CI, 1.013.94) were significantly linked to pastyear suicidal ideation.

Furthermore, pastyear alcohol use disorder, nicotine dependence, marijuana use, and marijuana use disorder were all tied to increased risk for pastyear suicidal ideation (all P < .001). The researchers also reported that 2.2% of older adults without either opioid or benzodiazepine misuse had pastyear suicidal ideation.

In addition, 25.4% of those who misused both medication classes endorsed past-year suicidal thoughts (aOR = 4.73; 95% CI, 2.0710.79), which was almost three times the prevalence of suicidal ideation in those with only opioid misuse (8.3%) or only benzodiazepine misuse (8.8%), according to the results.

“Together, these results suggest that older adults need to be screened for prescription opioid and/or benzodiazepine misuse and that those endorsing misuse or with signs of misuse (eg, early refill requests, inconsistent pill counts) also need to be screened for suicidal ideation,” Schepis and colleagues wrote.

“Use of prescription drug monitoring program databases is also encouraged to identify potential course of opioid and benzodiazepine medication in older adults,” they continued. “In addition to limiting the potential harms in older adults of prescription misuse, such screening could identify those atrisk for more frank suicidal behavior, limiting the consequences of [prescription drug misuse] and suicidality in older adults.” – by Savannah Demko

Disclosure: The authors report no relevant financial disclosures.