Very interesting study, abt 11-12 yr period that STOPPED TWO YEARS before the CDC 2016 opiate dosing guidelines were published, but after the DEA started cutting pharma production quotas.  The real BOTTOM LINE seems to be very VAGUE… only 18 states were involved without stating the percentage of the country’s total population.   The number of suicides from 2003 to 2014 was up about 50%.

And this quote from a “expert” …That’s an important stat, said Dr. Paul Nestadt of the department of psychiatry and behavioral health at the Johns Hopkins School of Medicine in Baltimore. “Opioids are depressants and they increase the risk of depression,”

Yet it is a known issue that chronic pain with under/untreated pain tend to have elevated anxiety and depression. Conversely, properly/optimized pain management tend to provide the pt with a “elevated” physical & mental “energy” and better QOL… resulting in less anxiety and depression.

Another interesting quote from the article: “Also, since chronic pain is not really coded well at the time of a suicide, this is probably an underestimate of the proportion of people who had chronic pain. We do know that chronic pain can be a deadly disease.”

There is a old quote credited to President Truman that this article seems to mirror:

Nourse, as economists are wont to do, was saying, “On the one hand … but then, on the other hand,” etc. After he left, Truman told Steelman that he had no idea what Nourse had just told him. Truman then said, “John, do you think you could find me a one-armed economist?”

Last year 2021, there was two fines/judgement from what can be described as “prescriber induced suicide” by pt committing suicides from having their long term pain meds reduced/eliminated. One was SEVEN MILLION and the other was ONE MILLION…   It is claimed that we have 50,000 suicides and one million attempted suicides EVERY YEAR…  this study indicates that 10.2 % where related to chronic pain…and many of us believe that those numbers or percents have increased since the 2016 CDC guidelines were published… and they may get worse with the new 2022 guidelines when they are published.

Using those numbers we are having abt 13 chronic pain pts committing suicide EVERY DAY and I have seen numbers that 22-24 veterans commit suicide every day… and we have all heard about what lousy care veterans get via Veterans Admin Hospital system.

POTENTIALLY THIRTEEN CHRONIC PAIN SUICIDES EVERY DAY… and last year … two “prescriber induced suicides” made the news and got a settlement and both of those were from 2018.  How many lawsuits could be filed if even one of these chronic pain pts committing suicide every day…  sent out a letter/email/video to local prosecutor, state AG, friends, local media claiming that they are exercising their final option to get out of a torturous level of pain and blame – point fingers – at the practitioner or organization they work for as the reason for their action. I don’t encourage suicides… but.. they happen… and it would appear that the near majority happens “behind a curtain” and/or off the radar…and the practitioners and the organizations that they work for … cause the limiting/denying of proper pain management without any consequences.  If the families of these pts … was able to get into the deep pockets of these healthcare corporations… could that change things…  as things are now going and have been going for the last decade +…  no change seems to be on the horizon.

Chronic pain may contribute to suicide, study warns

https://www.reuters.com/article/us-health-pain-suicide/chronic-pain-may-contribute-to-suicide-study-warns-idUSKCN1LQ2L6

(Reuters Health) – Nearly one in 10 suicide deaths in the U.S. occurs in people with chronic pain, a new study indicates.

The finding suggests chronic pain may be a risk factor for suicide, the study authors say.

While the study can’t prove that chronic pain contributed to people’s decisions to kill themselves, “we did see that mental health issues, such as depression and anxiety were more common among those with chronic pain,” said lead author Dr. Emiko Petrosky, a medical epidemiologist with the U.S. Centers for Disease Control and Prevention (CDC) in Atlanta.

It’s estimated that 25 million U.S. adults have some level of daily pain and 10.5 million of them have considerable pain every day, Petrosky and colleagues note in Annals of Internal Medicine.

“Health care providers caring for patients with chronic pain should be aware of the risk for suicide,” Petrosky told Reuters Health. “Chronic pain is a huge public health problem. It’s essential that we improve chronic pain management through integrated patient centered management that includes mental health care in addition to medications for these patients.”

Data for the study had been collected from 18 states between 2003 and 2014 by the CDC’s National Violent Death Reporting System.

Out of 123,181 suicide deaths in the study, the records for 10,789, or about 9 percent, included notations by officials – such as coroners, medical examiners and law enforcement officers – that indicated evidence of chronic pain.

The proportion of suicides committed by people suffering from chronic pain increased during the study, rising from 7.4 percent in 2003 to 10.2 percent in 2014. But Petrosky’s team also underscored the fact that the percentage of people battling chronic pain also rose during the same time period.

Back pain, cancer pain and arthritis pain accounted for a large proportion of the chronic pain conditions.

More than half of the people with chronic pain who killed themselves died from firearm related injuries, while 16.2 percent died from opioid overdose. Still, chronic pain sufferers were three times as likely as others to have tested positive for opioids when they died.

That’s an important stat, said Dr. Paul Nestadt of the department of psychiatry and behavioral health at the Johns Hopkins School of Medicine in Baltimore. “Opioids are depressants and they increase the risk of depression,” said Nestadt, who is not affiliated with the new research. “Depression is one of the highest risk factors for completing suicide.”

The new study can’t say anything about the state of chronic pain management in this country, said Dr. Michael L. Barnett, a health policy and management researcher at the Harvard T.H. Chan School of Public Health and a primary care physician at Brigham & Women’s Hospital in Boston

But we do know “there aren’t any medications that seem to be particularly effective for chronic pain,” said Barnett, who is not affiliated with the new study. “Both opioids and NSAIDs are pretty effective in treating acute pain, but not chronic pain. While people often want a pill that will fix things, comprehensive pain management is proven to be pretty effective.”

A problem with this kind of study is you don’t know what other risk factors people had, said Dr. Ajay D. Wasan, vice president for scientific affairs at the American Academy of Pain Medicine and a professor of anesthesia and psychiatry at the University of Pittsburgh Medical Center.

“Chronic pain is certainly an important risk factor, but we don’t know how important it is compared to other risk factors,” said Wasan, who was not affiliated with the new research.

“Also, since chronic pain is not really coded well at the time of a suicide, this is probably an underestimate of the proportion of people who had chronic pain. We do know that chronic pain can be a deadly disease.”

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