title: Suicidal ideation and suicide attempt across stages of nonmedical prescription opioid use and presence of prescription opioid disorders among U.S. adults.
abstract: OBJECTIVE
  This study compares the likelihood of suicidal ideation and suicide attempt across stages of nonmedical prescription opioid use and by presence of prescription opioid disorders (dependence and/or abuse) among adult respondents.
  
  
  METHODS
  In the 2009 National Survey on Drug Use and Health, 37,933 adult respondents were asked if they had thought about suicide or had attempted suicide in the past year. The likelihood of ideation and attempt were compared across the following four categories: (a) those who never used prescription opioids, (b) former users, (c) persistent users, and (d) recent-onset users. Weighted multinomial logistic regressions were used to examine if these stages and presence of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for prescription opioid disorders were associated with suicidal ideation and suicide attempt.
  
  
  RESULTS
  Five percent of respondents (n = 2,021) reported suicidal ideation; of these, 15% (n = 310) reported attempt. Former and persistent nonmedical prescription opioid users had greater odds of suicidal ideation than those who never used these medications nonmedically. The stages of prescription opioid use were not associated with suicide attempt. Presence of prescription opioid disorders among past-year prescription opioid users was associated with suicidal ideation but not suicide attempt.
  
  
  CONCLUSIONS
  The risk for suicidal ideation was greater in those who no longer used prescription opioids, in persistent users, and among nonmedical users who had a prescription opioid disorder compared with users without the disorder. The results suggest a need to continue monitoring for suicide risk even among those who have stopped using prescription opioids.
authors.affiliation: American Psychiatric Institute for Research and Education, Arlington, Virginia 22209, USA. jkuramoto@psych.org
authors.forename: S Janet
authors.initials: SJ
authors.lastname: Kuramoto
authors.forename: Howard D
authors.initials: HD
authors.lastname: Chilcoat
authors.forename: Jean
authors.initials: J
authors.lastname: Ko
authors.forename: Silvia S
authors.initials: SS
authors.lastname: Martins
mesh_terms: D000293:Adolescent; D000328:Adult; D003865:Major Depressive Disorder / Q000150:complications / Q000523:psychology; D005260:Female; D006306:Health Surveys / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009293:Opioid-Related Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D055553:Prescription Drugs / Q000009:adverse effects*; D012307:Risk Factors; D012651:Self Medication / Q000523:psychology* / Q000706:statistics & numerical data; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology
chemical_list: D055553:Prescription Drugs