Relationship of chronic pain and suicide

Abstract

Chronic pain patients are at increased risk for suicidality (suicidal ideations and actions). With data showing that chronic pain patients visit their physician within the month prior to their suicide, this creates an important opportunity for prevention and intervention. Numerous psychological processes underpin this risk, including depression, pain-related helplessness, desire for escape, fear of dying, catastrophizing, and mental defeat. Apart from risk factors similar to that of the general population, chronic pain patients may have specific factors that put them at increased risk of suicidality including pain duration, certain pain locations, and sleep disturbances. In regard to medications used to treat chronic pain, only opioids have been linked to increased risk of suicidality within chronic pain patients. These patients should be risk stratified, targeted with multispecialty therapy to aid in coping skills and psychiatric comorbidities, and screened on a regular basis to assess their level of suicidality.