Childhood Abuse and Suicidal Cognition in Adults with Opioid Use Disorder

Background: Childhood abuse (CA) is highly prevalent among individuals with opioid use disorder (OUD) and has previously been linked to an increased risk of suicidal ideation. We aimed to quantify the association between CA and suicidal ideation and cognition prior to accidental non-fatal opioid overdose. Methods: We conducted a secondary analysis from a study of adults with OUD (N = 98) from an inpatient substance use disorder unit. Participants completed questionnaires, assessing childhood abuse, history of overdose, and suicidal thoughts. Logistic and linear regressions were used to investigate our study variables. Results: A sample of 93 participants was included in analyses. CA was associated with a greater motivation to die prior to accidental overdose (B = 0.08, SE_b = 0.03, p < 0.01) and intention to die prior to accidental overdose (aOR = 1.05, 95% CI = 1.00, 1.10, p < 0.05) among those with a history of overdose (n = 64), but not greater overall suicidal ideation in the full sample (N = 93). CA was associated with history of suicide attempt (aOR = 1.06, 95% CI = 1.02, 1.10, p < 0.001), but no association was found with higher odds of accidental overdose (aOR = 1.03, 95% CI = 0.99, 1.07). Conclusions: Among a sample with severe OUD, CA was associated with greater motivation and intention to die prior to accidental overdose. It was also associated with higher odds of prior suicide attempt. These findings provide support that greater exposure to CA is a risk factor for potentially fatal events within this population.