Suicidality among individuals using fentanyl in Vancouver: a cross-sectional analysis of substance-use related characteristics

Background Individuals who use opioids report high rates of suicidal ideation and attempts. Opioid overdose is also discussed as having a suicidal root in fatalities. This association has not yet been explored in users of fentanyl.Objectives To investigate the prevalence of suicide ideation and lifetime suicide attempts among users of fentanyl, and examine their associations with substance-use related characteristics.Method Data was used from the Fentanyl Cohort Study, a cross-sectional survey of adults using fentanyl in an acute care hospital.Results Among 211 participants, 32.2% reported suicidal ideation in the past six months and 35.5% reported at least one suicide attempt in their lifetime (females: 45.2% vs. males: 30.9%). Suicidal ideation in the past six months was associated with use of multiple substances, harm reduction engagement, recent overdose history in the last six months, and higher perceived risk of overdose. Lifetime suicide attempt was associated with use of multiple substances and previous participation in substance use treatment. Diagnosis of mental illness was also associated with both outcomes.Conclusions Suicidality has clinical relevance among individuals who use fentanyl with underlying psychiatric distress. These findings highlight the importance in integrated support in the care of users of fentanyl.