Suicide risk and associated demographic and clinical correlates among primary care patients with recent drug use

ABSTRACT

Background: There is an increased need to prepare primary care clinicians to effectively gauge the risk of suicidal behavior occurring within primary care patients who may abuse drugs, especially those served in safety-net settings. Objectives: The objectives of this paper were to explore suicide risk in a population of individuals endorsing recent drug use, and to describe patient demographic, medical, psychiatric, social, and substance use characteristics across different levels of suicide risk. Methods: A total of 867 primary care patients with reported drug use in the previous 90 days were studied. Based upon their responses to two Addiction Severity Index questions, four suicide risk categories were constructed: (1) low risk; (2) moderate-low (suicidal ideation in the past 30 days); (3) moderate-high (history of a lifetime suicide attempt); and (4) high risk (history of a lifetime suicide attempt and suicidal ideation in the past 30 days). The association between suicide risk groups and demographic and clinical variables were assessed. Results: A total of 40% of primary care patients endorsing recent drug use reported a lifetime suicide attempt. Compared to individuals in other suicide risk groups, individuals at high suicide risk had higher rates of substance use severity, recently used two or more substances, and were more likely to have a comorbid psychiatric condition. Conclusion: These findings indicate that the percentage of patients with suicide risk may be higher among patients with recent drug use. Primary care clinicians should be aware that they may be encountering patients with suicide risk among those with recent drug use.

KEYWORDS:

• SBIRT
• substance use
• primary care
• suicide

Declarations of interest

Dr. Roy-Byrne reports receiving financial support as the Editor in Chief of Depression and Anxiety, Journal Watch Psychiatry, and UpToDate Psychiatry, and receiving stock options for consultation to Valant Medical Solutions (behavioral health EMR company), outside the submitted work. Dr. Ries reports receiving financial support from Janssen Pharmaceuticals, Inc., Alkermes, and Reckitt Benckiser Pharamaceutical, Inc. outside the submitted work. The other authors report no disclosures.

Additional information

Funding

The research was supported by grant R01 DA026014-01 from the National Institute on Drug Abuse.