Suicidal Risk Factors Associated With Opioid Analgesics Use

SNIIRAM Database

Suicide attempt, Analgesics, Opioid, pharmacoepiemiology

There is an increase in prescriptions for analgesics opioids and overdose mortality in France. In the United States, the consumption of opioid analgesics is associated with excess mortality, especially suicide. In France, the investigator team showed retrospectively a link between history of suicide attempt (SA) and use of analgesics in general elderly population. It is important to determine if there is a link between the prescription of opioid analgesics and suicide attempts, in a longitudinal study in general population. The originality of the project lies in: * the absence of a French epidemiological study on the link between opioid analgesics and suicide attempt / mortality despite the context of opioid crisis, * taking into account the terms of consumption of care

Main objective: To estimate the relative risk (Odds ratio) of SA associated with exposure to opioid analgesics in a case-crossover design study Secondary objectives: 1. To Compare the profile of subjects who attempted suicide versus subjects who had an accidental drug intoxication with opioids vs subjects who did not attempt suicide or did not have an accidental overdose with opioid analgesics (case-control design) 2. To Evaluate the dose-effect of opioid analgesics on the risk of SA (case-control and case-crossover design). 3. To Identify changes in care consumption (medical consultations, co-prescriptions, changes in analgesic doses) in the 3 months preceding a SA in patients who received at least one prescription for opioid analgesics in the same period. The Database is retrospective (2012-2017) Two methods will be used -case crossover study (reference period of 3 months preceding the SA versus 3 control periods of 3 months without SA.- Case control study (Age and gender matching) Case 1 = occurrence of a SA according to PMSI codes X60 to X84 between the date of the first delivery of opioid analgesics recorded in the SNIIRAM database since 2012 and December 2017; Case 2 = subjects who had accidental drug intoxication with opioid analgesics according to PMSI code T40; Controls = absence of SA and accidental opioid overdose

France