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. 2023 Nov-Dec:85:8-18.
doi: 10.1016/j.genhosppsych.2023.09.006. Epub 2023 Sep 10.

Suicide-related care among patients who have experienced an opioid-involved overdose

Bobbi Jo H Yarborough  1 , Scott P Stumbo  1 , Mary Jean Coleman  2 , Deborah S Ling Grant  3 , Jessica Hulsey  4 , Jennifer L Shaw  5 , Brian K Ahmedani  6 , Cambria Bruschke  7 , Clayton P A Carson  8 , Rachael Cooper  9 , Alison Firemark  1 , Douglas Hulst  10 , Stefan Massimino  1 , Lisa R Miller-Matero  6 , Jon R Swanson  11 , Anna Leonard  5 , Joslyn Westphal  6 , Karen J Coleman  12
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Suicide-related care among patients who have experienced an opioid-involved overdose

Bobbi Jo H Yarborough et al. Gen Hosp Psychiatry. 2023 Nov-Dec.

Abstract

Objective: Our objective was to describe suicide prevention care for individuals prescribed opioids or with opioid use disorder (OUD) and identify opportunities for improving this care.

Methods: Adult patients (n = 65) from four health systems with an opioid-involved overdose and clinicians (n = 21) who had contact with similar patients completed 30-60-min semi-structured interviews. A community advisory board contributed to development of all procedures, and interpretation and summary of findings.

Results: Patients were mostly female (59%), White (63%) and non-Hispanic (77%); 52 were prescribed opioids, 49% had diagnosed OUD, and 42% experienced an intentional opioid-involved overdose. Findings included: 1) when prescribed an opioid or treated for OUD, suicide risks were typically not discussed; 2) 35% of those with an intentional opioid-involved overdose and over 80% with an unintentional overdose reported no discussion of suicidal ideation when treated for the overdose; and 3) suicide-related follow-up care was uncommon among those with unintentional overdoses despite suicidal ideation being reported by >20%. Clinicians reported that when prescribing opioids or treating OUD, post-overdose suicide-related screening or counseling was not done routinely.

Conclusions: There were several opportunities to tailor suicide prevention care for patients who were treated for opioid-involved overdoses within health systems.

Keywords: Opioid overdose prevention; Provider behavior; Qualitative study; Suicidal ideation; Suicide risk screening.

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Conflict of interest statement

Declaration of Conflicts of Interest: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Journey map outlining a summary of what patients’ experiences and clinicians’ perceptions of suicide prevention care before, during, and after opioid-involved overdoses in four large, diverse health systems. The journey map is divided into the current state, assumptions and role expectations, and potential opportunities for improvement across all parts of the care process from prescribing opioids, treatment of opioid use disorder (OUD), treatment of an opioid-related overdose, and after the overdose during follow-up.
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