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Cited by 134Suicide and Self-Harm StudiesOpioid Use Disorder TreatmentHomicide, Infanticide, and Child Abuse

Chronic Pain Among Suicide Decedents, 2003 to 2014: Findings From the National Violent Death Reporting System

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Petrosky, Emiko, Harpaz, Rafael, Fowler, Katherine A., Bohm, Michele K., Helmick, Charles G., Yuan, Keming, Betz, Carter J.·2018·Annals of Internal Medicine
DOI 10.7326/m18-0830PMC PMC6913029
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Abstract

Background: More than 25 million adults in the United States have chronic pain. Chronic pain has been associated with suicidality, but previous studies primarily examined nonfatal suicidal behaviors rather than suicide deaths associated with chronic pain or the characteristics of such deaths. Objective: To estimate the prevalence of chronic pain among suicide decedents in a large multistate sample and to characterize suicide decedents with and without chronic pain. Design: Retrospective analysis of National Violent Death Reporting System (NVDRS) data. The NVDRS links death certificate, coroner or medical examiner, and law enforcement data collected by investigators, who often interview informants who knew the decedent to gather information on precipitating circumstances surrounding the suicide. Information is abstracted by using standard coding guidance developed by the Centers for Disease Control and Prevention. Setting: 18 states participating in the NVDRS. Participants: Suicide decedents with and without chronic pain who died during 1 January 2003 to 31 December 2014. Measurements: Demographic characteristics, mechanism of death, toxicology results, precipitating circumstances (mental health, substance use, interpersonal problems, life stressors), and suicide planning and intent. Results: Of 123 181 suicide decedents included in the study, 10 789 (8.8%) had evidence of chronic pain, and the percentage increased from 7.4% in 2003 to 10.2% in 2014. More than half (53.6%) of suicide decedents with chronic pain died of firearm-related injuries and 16.2% by opioid overdose. Limitation: The results probably underrepresent the true percentage of suicide decedents who had chronic pain, given the nature of the data and how they were captured. Conclusion: Chronic pain may be an important contributor to suicide. Access to quality, comprehensive pain care and adherence to clinical guidelines may help improve pain management and patient safety. Primary Funding Source: None.

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  • With the prevalence of pain being comorbid with psychological distress and related to rural residence it is paramount that these programs are accessible to those with chronic pain.

    “With the prevalence of pain being comorbid with psychological distress and related to rural residence it is paramount that these programs are accessible to those with chronic pain.1,2,69-71”

    From Remotely Delivered Psychologically Informed Mindful Movement Physical Therapy for Pain Care: A Framework for Operationalization (2023) · cites this paper as [70]

    The Discussion (page not provided) reports that mental health disorders were prevalent among suicide decedents with chronic pain and calls for access to coordinated pain and mental health care. Our copy does not establish an association between chronic pain and rural residence, so that part of the cited sentence is unsupported. (LLM, conf=0.86)

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  1. [2]Committee on Advancing Pain Research, Care, and Education; Board on Health Sciences Policy. Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. Washington, DC: National Academies Pr; 2011 Accessed at www.nap.edu/read/13172/chapter/1 on 27 March 2018. 22553896

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Authors
Petrosky, E., Harpaz, R., Fowler, K. A., Bohm, M. K., Helmick, C. G., Yuan, K., & Betz, C. J.
Affiliations
Centers for Disease Control and Prevention (US)
ORCID
Venue
Annals of Internal Medicine
Publisher
American College of Physicians
Published
2018-10-02
Volume
169
Issue
7
Pages
448-455
ISSN
  • 0003-4819 (ISSN-L)
  • 1539-3704
DOI
10.7326/m18-0830
PMC
PMC6913029
OpenAlex
W2890052915
Cited by
134
References
31
Citations by year
2026: 9 · 2025: 11 · 2024: 9 · 2023: 19 · 2022: 28 · 2021: 27 · 2020: 12 · 2019: 15 · 2018: 4
FWCI
17.00
Type
journal article
Language
en
Open access
Locations
  • Annals of Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institutes of Health (CC999999)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
  • Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
Keywords
chronic pain, suicide, suicide decedents, firearm deaths, opioid overdose, pain management, suicide planning, suicidal intent, National Violent Death Reporting System
MeSH terms
Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Child, Female, Humans, Male, Middle Aged, Retrospective Studies, Risk Factors, Sex Factors, Suicide, United States, Case-Control Studies, Young Adult, Chronic Pain

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