Prevalence and Correlates of Opioid-Involved Suicides in Maryland

Abstract

Objective

Involvement of opioids in suicides has doubled during the past two decades, worsening a major public health concern. This study examined the characteristics of opioid-involved suicides.

Methods

The sample of decedents (N = 12,038) in Maryland between 2006 and 2020 was used to compare the characteristics of opioid-involved suicides (n = 947) with suicides not involving opioids (n = 6,896) and accidental opioid deaths (n = 4,125). Direct comparisons were then made between opioid-involved suicides with and without the additional presence of non-opioid substances.

Results

Opioid-involved suicides were significantly more likely than suicides not involving opioids to occur among those aged 18–64 years, non-Hispanic Whites, and unemployed or disabled individuals. Opioid-involved suicides were more likely than accidental opioid deaths to occur among females, those aged <18 years, non-Hispanic Whites, and employed individuals. Of all suicides involved opioids, 45% involved other non-opioid substances. Polysubstance opioid suicides were significantly more likely than suicides involving opioids only to occur among non-Hispanic Whites.

Conclusions

Significant differences were observed in the demographic groups most at risk for opioid-involved suicide than other suicide or accidental opioid death. Among opioid-involved suicides, polysubstance involvement also represents a distinct group. These findings may enhance the targeting of prevention efforts.

HIGHLIGHTS

• Opioid-involved suicides differ from other suicides or accidental opioid deaths.

• In opioid-involved suicides, polysubstance involvement represents a distinct group.

• These findings may enhance the targeting of prevention efforts.

Keywords:

• Maryland
• opioid
• polysubstance
• suicide

ACKNOWLEDGMENTS

The authors of this manuscript are responsible for its content. Statements in the manuscript do not necessarily represent the official views of or imply endorsement by the AFSP.

DISCLOSURE STATEMENT

Dr. Susukida reported receiving research support from the AFSP, the National Institute on Drug Abuse (NIDA), and the Centers for Disease Control and Prevention (CDC) during the conduct of the study. Dr. Nestadt reported receiving research support from the AFSP (YIG-0-093-18). Dr. Kharrazi and Mr. Kitchen reported receiving research support from the National Institute of Mental Health (1R01MH124724 and 1R56-MH117560). Dr. Wilcox reported receiving research support from the National Institute of Mental Health.

Additional information

Funding

This work was supported by the American Foundation for Suicide Prevention (AFSP) under Grant YIG-R-002-19.

Notes on contributors

Ryoko Susukida

Ryoko Susukida, PhD, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

Paul S. Nestadt

Paul S. Nestadt, MD, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA and Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Hadi Kharrazi

Hadi Kharrazi, MD, PhD, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA and Division of Health Sciences Informatics, Johns Hopkins School of Medicine, Baltimore, MD, USA.

Holly C. Wilcox

Holly C. Wilcox, PhD, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, and Johns Hopkins University School of Education, Baltimore, MD, USA.