The Role of Opiates in Social Pain and Suicidal Behavior
Abstract
With more than 800,000 deaths by suicide each year and 20 to 30 times more suicide attempts worldwide, suicide is a major public health problem. Current treatments of SB are mainly based on pharmacological treatments that are not specific of SB (e.g. antidepressants), and new therapeutic targets are urgently needed. Recent data strengthen the ancient conception pain (social, psychic, physical) that is at the core of the suicidal process and should be incorporated in the clinical assessment of suicide risk. Then, the mechanisms involved in the regulation of pain may open new avenues regarding therapeutic perspectives. Opiates appear to be a promising candidate in treatment of SB. Indeed, since the last two decades, growing evidences suggest an implication of the opioid system in the pathophysiology of SB, this conduct to the elaboration of randomized controlled trials (RCTs) using opiates in patients with SB. Results suggesting an anti-suicidal effect of buprenorphine and the potential opioidergic-related anti-suicidal effect of ketamine both contribute to the growing interest in opiates use in SB. In this review, we will summarize a large part of the evidence that leads researchers and clinicians to be interested in the use of opiates for SB treatment and discuss on new opioid pharmacological options for suicidal patients.
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Preliminary evidence suggests low-dose buprenorphine may attenuate affective distress by modulating the endogenous opioid system.
“Nobile et al. [51] explored the role of opioids in social pain and suicidality, finding preliminary evidence that low-dose buprenorphine may attenuate affective distress by modulating the endogenous opioid system.”
From Targeting Psychological Pain After a Suicide Attempt: Scoping Review and Intervention Protocol (2026) · cites this paper as [51]
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Let’s Move Towards Precision Suicidology
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“Nobile et al. [51] explored the role of opioids in social pain and suicidality, finding prelimi-nary evidence that low-dose buprenorphine may attenuate affective distress by modulating the endogenous opioid system.”
- Authors
- Nobile, B., Lutz, P.-E., Olie, E., & Courtet, P.
- Affiliations
- Inserm (FR)
- Corresponding author
- Courtet, Philippe
- ORCID
- Courtet, Philippe
- Venue
- Current Topics in Behavioral Neurosciences
- Publisher
- Springer International Publishing
- Published
- 2020
- Volume
- 46
- Pages
- 197-210
- ISSN
- 1866-3370 (ISSN-L)
- 1866-3389
- OpenAlex
- W3082754357
- Cited by
- 24
- References
- 17
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 9 · 2023: 2 · 2022: 3 · 2021: 4
- FWCI
- 15.41
- Type
- book chapter
- Language
- en
- Open access
- closed
- Locations
- Current topics in behavioral neurosciences (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- opiates, opioid system, suicidal behavior, social pain, pain modulation, buprenorphine, ketamine, suicide risk assessment, opioid analgesics, suicide prevention
- MeSH terms
- Buprenorphine, Humans, Pain, Suicide, Attempted, Opiate Alkaloids, Suicidal Ideation
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