While suicides by drug or medicine overdose have decreased overall in recent years, new federal data published Wednesday raises flags in regard to several troubling exceptions.
Bucking the overall downward trend, intentional overdose deaths increased among teens and young adults ages 15 to 24. Black women and Americans ages 75 to 84 also saw an increase.
Experts hoped to address gaps in the existing research about who is at most risk of suicide by drug overdose. Their findings serve as a stark reminder that American teenagers and young adults are struggling with mental health problems and suicide.
Notably, the data ― which was calculated between 2015 and 2019 ― focuses on a period of time before the coronavirus pandemic. While there’s no concrete data yet on how the pandemic has affected these numbers, other evidence suggests suicidal thinking and behavior has increased among teens and young adults ever since COVID-19 emerged. The new research, along with the data we do have from the pandemic, highlights an urgent need to address mental health in these communities, according to experts.
And overall national data shows that drug overdoses have skyrocketed during the pandemic. Nearly 92,000 people died from drug overdoses in the U.S in 2020 — the largest number on record.
“An increase in these numbers in this population is concerning — and critically important to address — but the fact that it is increasing is not entirely surprising,” said psychiatrist Dr. Jessica Gold, director of wellness, engagement, and outreach in the department of psychiatry of Washington University in St. Louis. “Mental health concerns have been increasing in this group, particularly over COVID-19.”
Another challenge for researchers is determining whether overdose deaths are accidental or intentional deaths by suicide. There’s a chance that overdose suicide numbers are even further undercounted, making it an even bigger problem than the data shows.
“The distinction between accidental and intentional overdose has important clinical implications, as we must implement strategies for preventing both,” Dr. Nora Volkow, senior author on the study and director of the National Institute on Drug Abuse, said in a press release. “To do so requires that we screen for suicidality among individuals who use opioids or other drugs, and that we provide treatment and support for those who need it, both for mental illnesses and for substance use disorders.”
Despite those challenges, there is a pressing need to better track suicide by overdose. It can help reveal who is most at risk and point to new potential prevention strategies. For example, the new study found that intentional overdose deaths were lowest in December, suggesting the sense of optimism and social connection over the holidays may offer a protective effect, the study’s authors hypothesized.
How to spot and talk to a teen or young adult who is at risk
While there may be gaps in our current understanding of how widespread suicide by overdose is, it’s important to recognize the red flags. Parents should be on the lookout for signs that children are struggling. Those can include (but are not limited to): mood swings; problems eating or sleeping; or talking, writing or drawing about suicide.
Experts also say the new data underscores how important it is for parents and caregivers to talk to teens and young adults about the issue.
“I think it is important for parents to know that they can talk to their kids about suicide without their kids developing thoughts about suicide,” Gold said. “An open dialogue where your kids feel comfortable asking questions is key.”
These conversations should start young, as research suggests 8% of kids ages 9 to 10 have thought about suicide. And parents should be prepared for the fact that they might be difficult and uncomfortable. That is OK. (Here’s some guidance on how to approach it.)
Easy access to lethal methods — in this case, drugs or medication — can also contribute to suicide risk.
“Keep prescription medications up and away in a secure place,” Gold said. “We talk about safe storage with guns, and we need to talk about it with medication. If you remove access, you significantly decrease risk, especially in a more impulsive moment.”
Parents or caregivers who are taking any medications themselves should keep a count of how many pills they have and not give their child access to them, she said. Also, if children are on medication after a surgery or injury, parents should distribute them and make a point to check in on their mental health. All leftover medicine should be returned to the doctor’s office or pharmacy, she added.
“It is also important for parents to be aware that help for depression and opioid use disorder exists, and they can be managed successfully with the help of professionals,” Gold said. “Please ask for help if you, or your child, needs it. We often focus too much on the aftermath or the acute events, and not enough on prevention.”
If you or someone you know needs help, call 1-800-273-8255 for the National Suicide Prevention Lifeline. You can also text HOME to 741-741 for free, 24-hour support from the Crisis Text Line. Outside the U.S., please visit the International Association for Suicide Prevention for a database of resources.