Letters to the Editor

Opioid Deaths and ‘Para-Suicide’

I am writing in response to the article “APA Holds Congressional Briefing on Ending the Opioid Epidemic” in the May 5 issue. I applaud the engagement of then-APA President Maria A. Oquendo, M.D., Ph.D., with members of Congress and their staffs in helping to end the current national opioid overdose death epidemic. I would like to make an addition to her statement “Many deaths from opioid overdose … are actually suicides.”

In a letter published in 2009 in issue 4 of the American Journal on Addictions, I contrasted 31 intentional male suicide deaths principally with guns with 22 unintended “suicidal” deaths most often associated with opioids. They were related to a dangerous self-destructive lifestyle, not with a decision to die. An apt term for such unintended demise is “para-suicide.”

Furthermore, high opiate doses, presence of comorbid psychiatric diagnoses such as major depression or alcohol dependence, use of opioids not legally prescribed, and intractable pain are other factors that increase the risk of suicide. 

PETER BARGLOW, M.D. (Berkeley, Calif.) ■