Medications for Alcohol and Opioid Use Disorders and Risk of Suicidal Behavior, Accidental Overdoses, and Crime
Open accessAbstract
OBJECTIVE: The authors examined associations between medications for alcohol and opioid use disorders (acamprosate, naltrexone, methadone, and buprenorphine) and suicidal behavior, accidental overdoses, and crime. METHOD: In this total population cohort study, 21,281 individuals who received treatment with at least one of the four medications between 2005 and 2013 were identified. Data on medication use and outcomes were collected from Swedish population-based registers. A within-individual design (using stratified Cox proportional hazards regression models) was used to compare rates of suicidal behavior, accidental overdoses, and crime for the same individuals during the period when they were receiving the medication compared with the period when they were not. RESULTS: No significant associations with any of the primary outcomes were found for acamprosate. For naltrexone, there was a reduction in the hazard ratio for accidental overdoses during periods when individuals received treatment compared with periods when they did not (hazard ratio=0.82, 95% CI=0.70, 0.96). Buprenorphine was associated with reduced arrest rates for all crime categories (i.e., violent, nonviolent, and substance-related) as well as reduction in accidental overdoses (hazard ratio=0.75, 95% CI=0.60, 0.93). For methadone, there were significant reductions in the rate of suicidal behaviors (hazard ratio=0.60, 95% CI=0.40-0.88) as well as reductions in all crime categories. However, there was an increased risk for accidental overdoses among individuals taking methadone (hazard ratio=1.25, 95% CI=1.13, 1.38). CONCLUSIONS: Medications currently used to treat alcohol and opioid use disorders also appear to reduce suicidality and crime during treatment.
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Medications for opiate use disorders, methadone and buprenorphine, have been associated with reduced rates of completed suicide among persons with addictions.
“Medications for opiate use disorders (methadone and buprenorphine) have been associated with reduced rates of completed suicide among persons with addictions.67”
From Suicide (2020) · cites this paper as [67]
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- Authors
- Molero, Y., Zetterqvist, J., Binswanger, I. A., Hellner, C., Larsson, H., & Fazel, S.
- Affiliations
- Kaiser Permanente (US)
- ORCID
- Venue
- American Journal of Psychiatry
- Published
- 2018-10-01
- Volume
- 175
- Issue
- 10
- Pages
- 970-978
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- PMC
- PMC6169735
- OpenAlex
- W2887297165
- Cited by
- 60
- References
- 31
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 5 · 2023: 4 · 2022: 13 · 2021: 8 · 2020: 15 · 2019: 8 · 2018: 1
- FWCI
- 7.61
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Wellcome Trust (202836/Z/16/Z)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Keywords
- alcoholism, opioid use disorder, acamprosate, naltrexone, methadone, buprenorphine, suicidal behavior, accidental overdose, crime, arrest rates, addiction treatment
- MeSH terms
- Acamprosate, Adult, Aged, Alcohol Deterrents, Alcoholism, Buprenorphine, Crime, Female, Follow-Up Studies, Humans, Male, Methadone, Middle Aged, Naltrexone, Opioid-Related Disorders, Risk Factors, Cohort Studies, Young Adult, Opiate Substitution Treatment, Suicidal Ideation, Drug Overdose
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