Opioids contributed to more than 50,000 deaths in the United States in 2016, according to the recent figures from the CDC (Centers for Disease Control and Prevention). Some of these deaths are unintentional, while others chose to end their lives by committing suicide. Determining how many opioid overdose deaths are actually a suicide is tricky because it is often difficult to determine the person’s state of mind when they took the lethal dose. Furthermore, even when death appears to be a suicide, considering the mental health history and emotional status of the individual, can also shed additional light on the exact reason for death.
“Every struggle is different, and often the despair to end the emotional pain leads to an intentional end of life.”
How Often Are Opioid Overdoses a Suicide?
Suicide is the act of intentionally bringing about one’s own death. This creates an inherent problem for those left behind who are trying to understand the cause of a person’s death. Unless the individual left a clear suicide note or message, it is often impossible to understand a person’s mental state in the moments leading up to his or her death. This becomes even more complicated when death occurs from opioid overdose, as tens of thousands of people accidentally overdose each year.
Whenever a person dies due to a drug overdose, the coroner or medical examiner must note a cause of death on the death certificate. The person must also make a determination about whether the overdose was intentional (i.e., a suicide) or unintentional (i.e., an accident). Accidental overdose deaths might be due to taking the drug accidentally, miscalculating the dose of the drug, or taking a drug in error (such as when fentanyl was added to heroin without the person’s knowledge). If the explicit intent cannot be determined, the death certificate reads “event of undetermined intent.”
Because of the challenges of determining a specific intent, the precise number of opioid overdoses due to suicide is unknown. In one study examining overdose deaths in an Indiana county particularly hard hit by the opioid crisis, 16% of deaths were considered suicide while 4% were of undetermined intent. The issue with these studies is that the majority of these victims had a combination of different factors which contribute to their demise.
Some of the contributing factors that can lead to death are:
Intense depression, which takes people to a full sense of hopelessness.
An unknown lethal substance in the drug.
Low physiological tolerance at that moment.
Indifference to well-being, that leads to careless use.
Emotional despair – An increased dosage to end the emotional pain, without thinking of the physiological consequences.
Crying out for help – In those cases, they really don’t want to die, but show others how desperate they feel.
A psychotic episode in which voices will cause them to use a lethal dose.
Mental Health Factors Underlying Opioid Use
The popular narrative about opioid use paints addiction to painkillers or heroin as a biological disease, making it seem inevitable that a person would abuse drugs. While there is undoubtedly a genetic and/ or biological component to opioid addiction, it is essential to consider the mental health factors that perpetuate the condition. The majority of people who begin abusing opioids do not do so because it is fun or exciting to get high. Instead, they use the drugs to numb physical and emotional distress. Feeling depressed, hopeless, despairing, and dealing with complex emotional trauma causes many individuals to seek substances as a way to dull the pain.
When thinking about suicide in this light, it becomes clear that even overdoses deemed suicides are driven by more than a desire to die. A person who “intentionally” overdoses on heroin often feels a complete indifference to living or dying. The loneliness, despair, and hopelessness felt by that person lead to an extreme need not to feel. The drive to numb the emotional pain overrides any consideration of danger or risks.
Untreated depression is the leading cause of suicide and possibly the main reason for drug addiction. About 75% of those who commit suicide do exhibit warning signs before the act. It is crucial, to be aware of what the suicide warning signs are and try to provide the adequate mental health support with no delays.
Some common suicide warning signs are:
• Feeling an intense depression or sadness, most of the time.
• Making comments on death or suicide.
• Feeling hopeless.
• Abusing drugs or alcohol.
• Losing interest in relationships and activities.
• Giving away possessions.
• Unexpectedly writing a will.
• Feeling intense guilt or shame.
• Becoming reckless.
If you or someone you know is exhibiting some of the signs above, don’t ignore it! Take immediate action and seek professional help.
Always take suicide warning signs seriously. Suicide Prevention Lifeline
For Suicide Assistance and Prevention, CALL 1-800-273-8255
or visit https://suicidepreventionlifeline.org/
Toward a Mental Health-Informed Solution to the Opioid Crisis
In order to curb the number of people dying because of opioid use, we must address the underlying factors that perpetuate the drug use. Many people struggling with opioid addiction have gone through countless rounds of treatment. These continued treatment “failures” contribute to the person’s belief that he or she is terminally broken; that there is no hope and that they are undeserving of any happiness. However, it is often not the patient who has failed treatment, but the treatment that has failed the patient.
In their incessant focus on addiction, many treatment programs forget the individual behind the diagnosis. That leads the affected person to feel unseen, unheard, and lonely. Consequently, intensifying feelings of depression and despair. In the depths of that despair, an individual may choose to take a higher dose of heroin or painkillers, which can be at lethal proportions. To help people, we must focus and treat the person. We need to learn to see and hear the individual before placing judgment and expectations upon them. We also need to offer tolerance, compassion and a bit of humility for those around us. Maybe then, will we succeed in reducing the number of suicides and overdoses.
Published on April 2, 2018
Reviewed by Clare Waismann, CATC, Founder of Waismann Method® Advanced Treatment for Opiate Dependence
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