Medication treatment for opioid use disorder reduces suicide mortality

Use of medications for opioid use disorder (MOUD) leads to a remarkable decrease in suicide deaths, as well as external cause of and all-cause mortality, a study has shown.

This retrospective cohort study included patients from the Department of Veterans Affairs (VA) and ran from 2003 to 2017. Three data sources were linked, namely the VA Corporate Data Warehouse, the Centers for Medicare and Medicaid Services Claims Data, and the VA‒Department of Defense Mortality Data Repository.

The exposure of interest was MOUD, including initiation periods (first 14 days on treatment), stopping periods (first 14 days off treatment), stable time on treatment, and stable time off treatment (reference category). Finally, the authors measured the following outcomes: suicide mortality, external-cause mortality, and all-cause mortality in the 5 years following MOUD initiation.

At least 60,000 VA patients (mean age 46.5 years) were treated with MOUD, most of whom were male (92.8 percent).

The hazard ratios (HRs) during stable MOUD after adjusting for demographic characteristics, mental and physical health conditions, and healthcare utilization were 0.45 (95 percent confidence interval [CI], 0.32‒0.63) for suicide mortality, 0.35 (95 percent CI, 0.31‒0.40) for external-cause mortality, and 0.34 (95 percent CI, 0.31‒0.37) for all-cause mortality.

Moreover, starting periods of treatment with MOUD correlated with an adjusted HR of 0.55 (95 percent CI, 0.25‒1.21) for suicide mortality, while stopping periods for MOUD correlated with an adjusted HR of 1.38 (95 percent CI, 0.82‒2.34) for suicide death.

“Understanding the effectiveness of medication treatment for opioid use disorder to decrease the risk of suicide mortality may inform clinical and policy decisions,” the authors said.