Older Adults at Risk for Opioids and Suicide

New research by Assistant Professor Keith Chan of the School of Social Welfare finds while there is a higher risk for suicide in older and younger adults who misuse opioids, the prevalence in older adults is particularly concerning.

The findings were published in the Journal of Opioid Management (January/February 2019).

Chan and his team used weighted logistic regression analyses to examine the relationship between nonmedical prescription opioid use (NMPOU) over the past year with suicidal thoughts, plans and attempts. The results were separated by age group.

Findings from his study came from the 2016 National Survey on Drug Use and Health from the Substance Abuse and Mental Health Services Administration, which includes a nationally-representative cohort of 38,136 adults 18 and older.

School of Social Welfare Dean Lynn Warner said, “Dr. Chan’s research adds to the evidence about the complex interplay between sociodemographic characteristics, mental health and addiction, and helps point the way for population-based prevention and intervention efforts to minimize the negative consequences of opioid misuse.”

Chan’s study found that those who misused oxycodone, hydrocodone, morphine or fentanyl in the prior 12 months had a higher prevalence of suicidality than non-users. Those reporting opioid misuse were 71 percent more likely to have suicidal thoughts, 95 percent more likely to have a plan to take their own life, and more than twice as likely to have attempted suicide.

From left: Rubin Jennings, Priya Winston, Mary Moller and Keith Chan.

“Although those 18-24 have the highest prevalence of suicidality and NMPOU, the adjusted odds for NMPOU and suicidal thoughts were significantly higher for persons 50 and older. Older adults have some of the highest rates of suicide, and findings from this study highlight NMPOU as a potential risk factor for this outcome,” Chan noted in the article.

Four UAlbany students were co-authors on the piece. For three of the four, this was their first peer-reviewed journal publication. Co-authors were doctoral students Priya Winston, Jeffrey Trant and Mary Moller, all of the School of Social Welfare, and Rubin Jennings, a master’s student in the School of Criminal Justice.

According to Chan, future research is needed to investigate the impact of opioids on mental health pathology.

“There are different reasons for suicide and substance use, many of which are tied to specific life events and stages in their life course,” Chan said. “When it comes to mental health, older adults are an overlooked and undertreated population. While some older adults live vibrant, healthy lives, others experience declining physical health which can cause chronic pain, and may lead to prescription opioid use, and later, misuse and addiction. Without support and mental health treatment, older adults can become socially isolated, which is a risk factor for suicide.”

In response to the opioid epidemic, he said, public policy must include allocating resources to increase access to and use of mental health care, targeting older as well as younger populations to address the risk of suicide.

He recommended that physicians conduct more comprehensive screenings for mental health issues and suicide risk with patients who are prescribed opioids.

“There is a dire need for inter-professional collaborations, greater outreach, and more mental health professionals who can increase access and treatment for persons impacted by this growing epidemic,” he concluded.