Prescription Opioid Misuse and the Perceived Likelihood of Future Suicidal Behavior: Considering the Role of Suicide Capability Dimensions

Introduction In the past two decades, suicide attempts and deaths involving prescription opioids have sharply increased. Research is needed to understand how prescription opioid misuse may increase suicide risk. Contemporary suicide theories suggest opioid use may increase suicide capability by increasing pain tolerance, altering fears related to death, or increasing one's understanding of lethal doses and/or access to means. This study examined the role of these dimensions of suicide capability in the association between prescription opioid misuse and self‐reported likelihood of future suicidal behaviors. Methods Individuals with chronic pain, past year depression, and a current prescription of opioids for pain ( N = 166) completed assessments of opioid misuse, suicide capability (i.e., fearlessness about death, pain tolerance, and suicide preparation and rehearsal), and suicidal behaviors. Results Analyses demonstrated significant indirect relations of prescription opioid misuse to the perceived future likelihood of suicide planning and attempts (both in general and involving opioids specifically) through suicide capability in the form of suicide preparation and rehearsal, controlling for suicide attempt history. Conclusion Findings suggest that prescription opioid misuse may increase suicide risk by increasing familiarity with a potential suicide method, consistent with extant literature highlighting the role of practical suicide capability in suicide risk.