Substance use disorders and risk of suicide in a general US population: a case control study
Abstract Background Prior research suggests that substance use disorders (SUDs) are associated with risk of suicide mortality, but most previous work has been conducted among Veterans Health Administration patients. Few studies have examined the relationship between SUDs and suicide mortality in gen...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-02-01
|
| Series: | Addiction Science & Clinical Practice |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13722-020-0181-1 |
| _version_ | 1828492406669967360 |
|---|---|
| author | Frances L. Lynch Edward L. Peterson Christine Y. Lu Yong Hu Rebecca C. Rossom Beth E. Waitzfelder Ashli A. Owen-Smith Samuel Hubley Deepak Prabhakar L. Keoki Williams Arne Beck Gregory E. Simon Brian K. Ahmedani |
| author_facet | Frances L. Lynch Edward L. Peterson Christine Y. Lu Yong Hu Rebecca C. Rossom Beth E. Waitzfelder Ashli A. Owen-Smith Samuel Hubley Deepak Prabhakar L. Keoki Williams Arne Beck Gregory E. Simon Brian K. Ahmedani |
| author_sort | Frances L. Lynch |
| collection | DOAJ |
| description | Abstract Background Prior research suggests that substance use disorders (SUDs) are associated with risk of suicide mortality, but most previous work has been conducted among Veterans Health Administration patients. Few studies have examined the relationship between SUDs and suicide mortality in general populations. Our study estimates the association of SUDs with suicide mortality in a general US population of men and women who receive care across eight integrated health systems. Methods We conducted a case–control study using electronic health records and claims data from eight integrated health systems of the Mental Health Research Network. Participants were 2674 men and women who died by suicide between 2000–2013 and 267,400 matched controls. The main outcome was suicide mortality, assessed using data from the health systems and confirmed by state death data systems. Demographic and diagnostic data on substance use disorders and other health conditions were obtained from each health system. First, we compared descriptive statistics for cases and controls, including age, gender, income, and education. Next, we compared the rate of each substance use disorder category for cases and controls. Finally, we used conditional logistic regression models to estimate unadjusted and adjusted odds of suicide associated with each substance use disorder category. Results All categories of substance use disorders were associated with increased risk of suicide mortality. Adjusted odds ratios ranged from 2.0 (CI 1.7, 2.3) for patients with tobacco use disorder only to 11.2 (CI 8.0, 15.6) for patients with multiple alcohol, drug, and tobacco use disorders. Substance use disorders were associated with increased relative risk of suicide for both women and men across all categories, but the relative risk was more pronounced in women. Conclusions Substance use disorders are associated with significant risk of suicide mortality, especially for women, even after controlling for other important risk factors. Experiencing multiple substance use disorders is particularly risky. These findings suggest increased suicide risk screening and prevention efforts for individuals with substance use disorders are needed. |
| first_indexed | 2024-12-11T11:19:52Z |
| format | Article |
| id | doaj.art-cfff0a7a7f1e4b5691d7986f604e7e9c |
| institution | Directory Open Access Journal |
| issn | 1940-0640 |
| language | English |
| last_indexed | 2024-12-11T11:19:52Z |
| publishDate | 2020-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Addiction Science & Clinical Practice |
| spelling | doaj.art-cfff0a7a7f1e4b5691d7986f604e7e9c2022-12-22T01:09:12ZengBMCAddiction Science & Clinical Practice1940-06402020-02-011511910.1186/s13722-020-0181-1Substance use disorders and risk of suicide in a general US population: a case control studyFrances L. Lynch0Edward L. Peterson1Christine Y. Lu2Yong Hu3Rebecca C. Rossom4Beth E. Waitzfelder5Ashli A. Owen-Smith6Samuel Hubley7Deepak Prabhakar8L. Keoki Williams9Arne Beck10Gregory E. Simon11Brian K. Ahmedani12Kaiser Permanente Northwest, Center for Health ResearchPublic Health Sciences, Henry Ford Health SystemDepartment of Population Medicine, Harvard Medical SchoolCenter for Health Policy and Health Services Research, Henry Ford Health SystemHealthPartners, Institute for Education and ResearchKaiser Permanente Hawaii, Center for Health ResearchSchool of Public Health, Georgia State UniversityDepartment of Family Medicine, University of Colorado, DenverBehavioral Health Services, Henry Ford Health SystemCenter for Health Policy and Health Services Research, Henry Ford Health SystemKaiser Permanente Colorado, Institute for Health ResearchKaiser Permanente Washington, Health Research InstituteCenter for Health Policy and Health Services Research, Henry Ford Health SystemAbstract Background Prior research suggests that substance use disorders (SUDs) are associated with risk of suicide mortality, but most previous work has been conducted among Veterans Health Administration patients. Few studies have examined the relationship between SUDs and suicide mortality in general populations. Our study estimates the association of SUDs with suicide mortality in a general US population of men and women who receive care across eight integrated health systems. Methods We conducted a case–control study using electronic health records and claims data from eight integrated health systems of the Mental Health Research Network. Participants were 2674 men and women who died by suicide between 2000–2013 and 267,400 matched controls. The main outcome was suicide mortality, assessed using data from the health systems and confirmed by state death data systems. Demographic and diagnostic data on substance use disorders and other health conditions were obtained from each health system. First, we compared descriptive statistics for cases and controls, including age, gender, income, and education. Next, we compared the rate of each substance use disorder category for cases and controls. Finally, we used conditional logistic regression models to estimate unadjusted and adjusted odds of suicide associated with each substance use disorder category. Results All categories of substance use disorders were associated with increased risk of suicide mortality. Adjusted odds ratios ranged from 2.0 (CI 1.7, 2.3) for patients with tobacco use disorder only to 11.2 (CI 8.0, 15.6) for patients with multiple alcohol, drug, and tobacco use disorders. Substance use disorders were associated with increased relative risk of suicide for both women and men across all categories, but the relative risk was more pronounced in women. Conclusions Substance use disorders are associated with significant risk of suicide mortality, especially for women, even after controlling for other important risk factors. Experiencing multiple substance use disorders is particularly risky. These findings suggest increased suicide risk screening and prevention efforts for individuals with substance use disorders are needed.http://link.springer.com/article/10.1186/s13722-020-0181-1Substance use disordersSuicideAlcohol use disorderDrug use disorders |
| spellingShingle | Frances L. Lynch Edward L. Peterson Christine Y. Lu Yong Hu Rebecca C. Rossom Beth E. Waitzfelder Ashli A. Owen-Smith Samuel Hubley Deepak Prabhakar L. Keoki Williams Arne Beck Gregory E. Simon Brian K. Ahmedani Substance use disorders and risk of suicide in a general US population: a case control study Addiction Science & Clinical Practice Substance use disorders Suicide Alcohol use disorder Drug use disorders |
| title | Substance use disorders and risk of suicide in a general US population: a case control study |
| title_full | Substance use disorders and risk of suicide in a general US population: a case control study |
| title_fullStr | Substance use disorders and risk of suicide in a general US population: a case control study |
| title_full_unstemmed | Substance use disorders and risk of suicide in a general US population: a case control study |
| title_short | Substance use disorders and risk of suicide in a general US population: a case control study |
| title_sort | substance use disorders and risk of suicide in a general us population a case control study |
| topic | Substance use disorders Suicide Alcohol use disorder Drug use disorders |
| url | http://link.springer.com/article/10.1186/s13722-020-0181-1 |
| work_keys_str_mv | AT francesllynch substanceusedisordersandriskofsuicideinageneraluspopulationacasecontrolstudy AT edwardlpeterson substanceusedisordersandriskofsuicideinageneraluspopulationacasecontrolstudy AT christineylu substanceusedisordersandriskofsuicideinageneraluspopulationacasecontrolstudy AT yonghu substanceusedisordersandriskofsuicideinageneraluspopulationacasecontrolstudy AT rebeccacrossom substanceusedisordersandriskofsuicideinageneraluspopulationacasecontrolstudy AT bethewaitzfelder substanceusedisordersandriskofsuicideinageneraluspopulationacasecontrolstudy AT ashliaowensmith substanceusedisordersandriskofsuicideinageneraluspopulationacasecontrolstudy AT samuelhubley substanceusedisordersandriskofsuicideinageneraluspopulationacasecontrolstudy AT deepakprabhakar substanceusedisordersandriskofsuicideinageneraluspopulationacasecontrolstudy AT lkeokiwilliams substanceusedisordersandriskofsuicideinageneraluspopulationacasecontrolstudy AT arnebeck substanceusedisordersandriskofsuicideinageneraluspopulationacasecontrolstudy AT gregoryesimon substanceusedisordersandriskofsuicideinageneraluspopulationacasecontrolstudy AT briankahmedani substanceusedisordersandriskofsuicideinageneraluspopulationacasecontrolstudy |