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Access to lethal drugs and economic instability contribute to higher suicide rates, the CU Boulder study found

Mar. 6—Access to lethal drugs and rising economic hardship matter as we look at rising suicide rates among American adults.

Increased access to potentially deadly opioids has made it easier for women to die by suicide, according to a new study from the University of Colorado Boulder. Additionally, less support from the federal government during tough economic times contributed to rising suicide rates among American adults between the 1990s and 2017.

“It doesn’t have to be this way,” says Daniel Simon, first author of the study and a doctoral candidate at CU Boulder in sociology. “American life is becoming increasingly dangerous. It is becoming increasingly uncertain, and that has implications or consequences for suicide mortality. I think these are the result of policy choices, but I think they can be solved or remedied by strengthening social safety nets, better regulating pharmaceuticals, and making American life safer.”

The researchers looked at broader patterns and causes for the national increase in suicide deaths, rather than individual risk factors. They analyzed 16 million deaths among American adults between 1990 and 2017 and distinguished the nearly 600,000 suicide deaths from intentional poisoning and non-poisoning. Data from 1997 and 2007 revealed two notable spikes in suicide deaths.

The year 1997 marks one year after opioids such as OxyContin were first used. Prescription opioids were approved by the Food and Drug Administration in 1995 and put on the market in 1996.

“Female suicide rates from poisoning changed course and started to increase about 2% per year after experiencing a decline,” Simon said. “So they started to rise at the same time that OxyContin and other opioids (painkillers) came onto the market.”

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The other spike in suicide deaths occurred in 2007, in line with the onset of the housing crisis and financial crash that sparked the Great Recession, which caused interest rates to rise and continue to rise.

“The fact that (suicide) deaths are so strongly associated with changes in the drug and economic climate in the United States has given us a greater understanding of the importance of structural factors shaping public health in the U.S.,” said Ryan Masters, CU Boulder -sociology. professor and senior author of the study.

Lena Heilmann, director of the Colorado Department of Public Health and Environment’s Office of Suicide Prevention, said economic stability and safety of lethal means are two of the important factors that can contribute to and increase suicide risk.

“We have long seen that suicide rates in the United States rise during economically stressful times, such as recessions, periods of high unemployment, rising poverty rates and difficulty covering expenses such as medical, food and housing bills,” Heilmann said. “Economically stressful times can also worsen the prevalence of homelessness and evictions, which can also contribute to suicide risk. Reducing these economic stressors can help prevent suicide.”

With the federal government taking a “backseat position,” Masters said this has increased Americans’ vulnerability to “boom-and-bust” economic cycles. When we look at home prices, unemployment and poverty in US states from 1990 to 2017, there is a strong correspondence between changes in these economic indicators and suicide rates in states.

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“If a state intervenes quite aggressively in economic policy and the expansion of the welfare state, that can soften and soften the blow to a population,” Masters said.

He said the conversation needs to move away from “despair narrative thinking” and that only poor mental health should be discussed when discussing suicide mortality rates.

“We would like to see the conversation broaden and policymakers take into account that the proliferation of firearms and drugs and the federal government’s retreat from providing economic security to the public, especially in times of economic downturn, is a dangerous and encouraging the deadly environment in which the United States lives,” Masters said.

The researchers noted that the increase in suicide deaths they saw was not due to more suicide attempts or more suicidal thoughts, but rather the prevalence of lethal means. Between the 1990s and 2006, non-toxin suicide deaths declined, and the only factor causing this increase was an increase in toxin deaths.

“If you were to consider poisonings as a cause of suicide deaths among women in the U.S., there would have been no increase in suicide mortality rates between 1990 and 2007,” Masters said.

The lethality of agents matters, Heilmann said. Most people who feel suicidal do not attempt suicide, and temporarily removing lethal substances from an environment can save a life. For every death by suicide, approximately 275 people have suicidal thoughts but do not attempt it.

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Firearms are the leading cause of suicide deaths among all Coloradans, especially men. For women, CDPHE considers firearms and asphyxiation as the top two methods of suicide death in Colorado, closely followed by overdose or poisoning.

“In Colorado, women attempt suicide by overdose and die at higher rates than men, according to our most recent data,” Heilmann said.

Nationally, suicide rates have increased slightly over time. In Colorado, suicide death rates have remained statistically stable. In Colorado, 997 men and 290 women died by suicide in 2022.

“Colorado’s suicide death rate has remained statistically stable overall. There has been no statistically significant change in the age-adjusted suicide death rate since 2014. In fact, our Colorado data showed a slight overall decline in 2022 compared to 2021,” Heilmann said, adding, “We hope these are optimistic signs that by working together we can continue to reduce and lower the suicide rate among all ages here in Colorado.”

Masters said expanding government programs such as access to welfare and health care and reducing unemployment can be seen as tools for suicide prevention.

“We must recommit ourselves to the good well-being of the American people or we will continue to see these horrible, horrific and terrible trends that we are documenting,” Masters said.

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Sources:

Those seeking support for themselves or others can call Colorado Crisis Services at 844-493-8255 or call or text 988 for the National Suicide and Crisis Prevention Lifeline.

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