Zaccheus J Ahonle1, Huanguang Jia1, Stephen A Mudra1, Sergio Romero1, Gail Castaneda1, Charles Levy1. 1. is a Research Assistant, is a Research Health Scientist, is a Health Science Specialist, , all at Veterans Rural Health Resource Center in Gainesville, Florida. is the Chief of Primary Care, Pain Management, and is the Chief of Physical Medicine and Rehabilitation, both at Gainesville VA Medical Center. Zaccheus Ahonle is an Assistant Professor in the Department of Counseling, Educational Psychology & Foundations at Mississippi State University, and Sergio Romero is a Research Assistant Professor, at the University of Florida in Gainesville.
Abstract
BACKGROUND: Suicide is the 10th leading cause of death in the US, primarily from drug overdose. In 2017, 67.8% of drug overdoses were with prescription opioids. The rate of opioid use disorder among patients in the Veterans Health Administration (VHA) is 7 times higher than that of non-VHA enrollees. This study compares the incidence of overdose and suicide across facility, regional, and national levels in the VHA system in the context of a multispecialty opioid risk reduction program at the North Florida/South Georgia Veteran Health System (NF/SGVHS). METHODS: This retrospective study used fiscal years 2012 to 2016 overdose and suicide aggregate data from the US Department of Veterans Affairs (VA) Support Service Center medical diagnosis cube and VA Suicide Prevention Program. Overdose data were aggregated by facility and fiscal year, and overdose rates (per 1,000 individuals) were calculated. RESULTS: The average annual rate of overdose diagnosis at NF/SGVHS during the study period was slightly higher (16.8 per 1,000) compared with its region (16.0 per 1,000), and VHA national (15.3 per 1,000) rates. The NF/SGVHS had the lowest average annual rate of suicide (9.1 per 100,000) during the study period, which was one-quarter of the VHA national rate. CONCLUSIONS: NF/SGVHS developed and implemented a biopsychosocial model of pain treatment that includes primary care integrated with mental health and addiction services. The presence of this program during a period when the facility was tapering opioid prescriptions could explain the relative reduced suicide rate.
BACKGROUND: Suicide is the 10th leading cause of death in the US, primarily from drug overdose. In 2017, 67.8% of drug overdoses were with prescription opioids. The rate of opioid use disorder among patients in the Veterans Health Administration (VHA) is 7 times higher than that of non-VHA enrollees. This study compares the incidence of overdose and suicide across facility, regional, and national levels in the VHA system in the context of a multispecialty opioid risk reduction program at the North Florida/South Georgia Veteran Health System (NF/SGVHS). METHODS: This retrospective study used fiscal years 2012 to 2016 overdose and suicide aggregate data from the US Department of Veterans Affairs (VA) Support Service Center medical diagnosis cube and VA Suicide Prevention Program. Overdose data were aggregated by facility and fiscal year, and overdose rates (per 1,000 individuals) were calculated. RESULTS: The average annual rate of overdose diagnosis at NF/SGVHS during the study period was slightly higher (16.8 per 1,000) compared with its region (16.0 per 1,000), and VHA national (15.3 per 1,000) rates. The NF/SGVHS had the lowest average annual rate of suicide (9.1 per 100,000) during the study period, which was one-quarter of the VHA national rate. CONCLUSIONS: NF/SGVHS developed and implemented a biopsychosocial model of pain treatment that includes primary care integrated with mental health and addiction services. The presence of this program during a period when the facility was tapering opioid prescriptions could explain the relative reduced suicide rate.
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