Inconsistent Self-Reports of Lifetime Suicide Attempts During Residential Treatment for Opioid Use Disorder

Objective: Individuals with opioid use disorder (OUD) are disproportionately at risk for suicide. Residential OUD treatment programs routinely assess suicide risk factors. However, the degree to which patients consistently self report lifetime suicide attempts (LSAs) on these measures is unknown. Using patient data from electronic health records, we examined the prevalence of self-reported LSAs, consistency of reporting on assessment measures within one treatment episode and across multiple episodes, and predictors of consistent reporting. Methods: Our sample consisted of all patient records for residential OUD treatment from 12/01/2020- 11/30/2021 with data on LSAs (N = 1,206). Three self-report assessments conducted by clinical staff during the treatment episodes measured LSAs. Results: LSAs were reported during 22% of residential treatment episodes on at least one measure. Within one treatment episode, 13% of individuals inconsistently self-reported LSAs across the different measures, and across multiple episodes, 23%. Those who were younger, female, identified as LGB, endorsed co-occurring anxiety or depressive symptoms and reported lifetime intravenous opioid use were more likely to inconsistently self report LSAs. Conclusions: These results suggest that single administration self-report instruments may be insufficient to adequately assess LSAs in patients with OUD. Care should be taken to assess suicide in this population that is already at increased risk.