Suicidal motivations among opioid overdose survivors: Replication and extension

Background: Several studies suggest suicidal motivation may contribute to opioid overdose fatalities in people with opioid use disorder. In this study, we sought to replicate and extend prior findings suggesting that a desire to die is common prior to nonfatal opioid overdose in people with opioid use disorder. Methods: Adults receiving inpatient detoxification and stabilization who reported a history of opioid overdose (N = 60) completed questions about suicidal cognition prior to their most recent overdose. Results: Approximately 45% reported some desire to die prior to their most recent overdose, with 20% reporting they had some intention to die. The correlation between these ratings was of a moderate magnitude (ρ = 0.58). Almost 40% of the sample perceived no risk of overdose prior to their most recent overdose event, suggesting a significant underestimation of risk in this population. Conclusions: Desire to die was common in adults with opioid use disorder prior to nonfatal opioid overdose events, and 1 in 5 people with a history of opioid overdose reported intention to die prior to their most recent opioid overdose. Careful assessment of suicidal cognition in this population may improve prevention of opioid overdose deaths.