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Journal Article

Citation

Yarborough BJH, Stumbo SP, Coleman MJ, Ling Grant DS, Hulsey J, Shaw JL, Ahmedani BK, Bruschke C, Carson CPA, Cooper R, Firemark A, Hulst D, Massimino S, Miller-Matero LR, Swanson JR, Leonard A, Westphal J, Coleman KJ. Gen. Hosp. Psychiatry 2023; 85: 8-18.

Copyright

(Copyright © 2023, Elsevier Publishing)

DOI

10.1016/j.genhosppsych.2023.09.006

PMID

37717389

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.


Language: en

Keywords

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

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