IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v381y2025ics0277953625006148.html

Mental health behaviors and suicide risk among White and Black adults with Opioid Use Disorder

Author

Listed:
  • Szlyk, Hannah S.
  • Lew, Daphne
  • Li, Xiao
  • Filiatreau, Lindsey M.
  • Peoples, JaNiene
  • Kasson, Erin
  • Cavazos-Rehg, Patricia

Abstract

This study explores differences in depression and anxiety symptoms and suicidal behaviors by symptom severity and race among White and Black adults with Opioid Use Disorder (OUD). We examine the viability of using PHQ-9 and GAD-7 symptoms scores to indicate past suicidal behavior by race. We analyze baseline data among individuals who were enrolled in a supplemental digital intervention intended to support adults with OUD in recovery. White (n = 345) or Black (n = 76) individuals were included in the analytic sample. Participants completed an online survey on depression (PHQ-9) and anxiety (GAD-7) symptoms, past 30-day (P30D) suicidal ideation (yes/no), and lifetime suicide attempts (yes/no). Descriptive statistics were calculated; mean symptom scores were compared by race. Race-stratified precision-recall (PR) curves were used to determine the extent to which mental health scores indicated P30D suicidal ideation and the optimal cut points for each measure. Whites had significantly higher depression and anxiety scores than Black participants. When comparing past suicidal behaviors, there were no significant differences by race. A larger proportion of Black participants with moderate or severe depression and anxiety endorsed past suicidal behavior compared to Whites. PR curves and area under the curve values suggested that optimal cut-points for mental health scores as an indicator for suicidal ideation differed by race. Alone, mental health symptom severity and total scores may not be ideal indicators of suicide risk. Mental health screenings plus suicide risk evaluations are recommended for OUD patients, especially Black Americans.

Suggested Citation

  • Szlyk, Hannah S. & Lew, Daphne & Li, Xiao & Filiatreau, Lindsey M. & Peoples, JaNiene & Kasson, Erin & Cavazos-Rehg, Patricia, 2025. "Mental health behaviors and suicide risk among White and Black adults with Opioid Use Disorder," Social Science & Medicine, Elsevier, vol. 381(C).
    • Handle: RePEc:eee:socmed:v:381:y:2025:i:c:s0277953625006148
    DOI: 10.1016/j.socscimed.2025.118283
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953625006148
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2025.118283?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to

    for a different version of it.

    References listed on IDEAS

    as
    1. Hansen, H. & Netherland, J., 2016. "Is the prescription opioid epidemic a white problem?," American Journal of Public Health, American Public Health Association, vol. 106(12), pages 2127-2129.
    2. Jones, C.M. & Campopiano, M. & Baldwin, G. & McCance-Katz, E., 2015. "National and state treatment need and capacity for opioid agonist medication-assisted treatment," American Journal of Public Health, American Public Health Association, vol. 105(8), pages 55-63.
    3. Scott, M. & Wilcox, H. & Huo, Y. & Turner, J.B. & Fisher, P. & Shaffer, D., 2010. "School-based screening for suicide risk: Balancing costs and benefits," American Journal of Public Health, American Public Health Association, vol. 100(9), pages 1648-1652.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Mitchell, Penelope & Samsel, Steven & Curtin, Kevin M. & Price, Ashleigh & Turner, Daniel & Tramp, Ryan & Hudnall, Matthew & Parton, Jason & Lewis, Dwight, 2022. "Geographic disparities in access to Medication for Opioid Use Disorder across US census tracts based on treatment utilization behavior," Social Science & Medicine, Elsevier, vol. 302(C).
    2. Ellen Bouchery & Judith Dey, "undated". "Substance Use Disorder Workforce," Mathematica Policy Research Reports 47d4d14a7a32485eba249dfb3, Mathematica Policy Research.
    3. Jayme E. Walters & Aubrey E. Jones & Aaron R. Brown & Dorothy Wallis, 2022. "Impacts of the COVID-19 Pandemic on a Rural Opioid Support Services Program," IJERPH, MDPI, vol. 19(18), pages 1-12, September.
    4. Matthew T. Knowles, 2022. "How access to addictive drugs affects the supply of substance abuse treatment: Evidence from Medicare Part D," Health Economics, John Wiley & Sons, Ltd., vol. 31(8), pages 1649-1675, August.
    5. Ebrahimi, Chantel T. & Song, Hannah & Machado, Monica & Segura, Pamela & Espinosa, Adriana & Polanco-Roman, Lillian, 2024. "Racism-related experiences and substance use: A systematic and meta-analytic review," Social Science & Medicine, Elsevier, vol. 362(C).
    6. Johanna Catherine Maclean & Brendan Saloner, 2019. "The Effect of Public Insurance Expansions on Substance Use Disorder Treatment: Evidence from the Affordable Care Act," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 38(2), pages 366-393, March.
    7. Guo, Jiapei & Kilby, Angela E. & Marks, Mindy S., 2024. "The impact of scope-of-practice restrictions on access to medical care," Journal of Health Economics, Elsevier, vol. 94(C).
    8. Emanuel Krebs & Jeong E. Min & Elizabeth Evans & Libo Li & Lei Liu & David Huang & Darren Urada & Thomas Kerr & Yih-Ing Hser & Bohdan Nosyk, 2017. "Estimating State Transitions for Opioid Use Disorders," Medical Decision Making, , vol. 37(5), pages 483-497, July.
    9. Baumgart-McFarland, Madison & Chiarello, Elizabeth & Slay, Tayla, 2022. "Reluctant Saviors: Professional ambivalence, cultural imaginaries, and deservingness construction in naloxone provision," Social Science & Medicine, Elsevier, vol. 309(C).
    10. Mary A. Burke, 2019. "Access to medication-assisted treatment for opioid use disorder: is Rhode Island different, and why?," Current Policy Perspectives 19-2, Federal Reserve Bank of Boston.
    11. Shellae Versey, H. & Cogburn, Courtney C. & Wilkins, Clara L. & Joseph, Nakita, 2019. "Appropriated racial oppression: Implications for mental health in Whites and Blacks," Social Science & Medicine, Elsevier, vol. 230(C), pages 295-302.
    12. Kerrison, Erin M., 2018. "Exploring how prison-based drug rehabilitation programming shapes racial disparities in substance use disorder recovery," Social Science & Medicine, Elsevier, vol. 199(C), pages 140-147.
    13. Tang, Shichao & Matjasko, Jennifer L. & Harper, Christopher R. & Rostad, Whitney L. & Ports, Katie A. & Strahan, Andrea E. & Florence, Curtis, 2021. "Impact of Medicaid expansion and methadone coverage as a medication for opioid use disorder on foster care entries during the opioid crisis," Children and Youth Services Review, Elsevier, vol. 130(C).
    14. Caroline A King & Honora Englander & P Todd Korthuis & Joshua A Barocas & K John McConnell & Cynthia D Morris & Ryan Cook, 2021. "Designing and validating a Markov model for hospital-based addiction consult service impact on 12-month drug and non-drug related mortality," PLOS ONE, Public Library of Science, vol. 16(9), pages 1-14, September.
    15. Aparna Soni & Lindsey Bullinger & Christina Andrews & Amanda Abraham & Kosali Simon, 2024. "The impact of state Medicaid eligibility and benefits policy on neonatal abstinence syndrome hospitalizations," Contemporary Economic Policy, Western Economic Association International, vol. 42(1), pages 25-40, January.
    16. Meinhofer, Angélica & Witman, Allison E., 2018. "The role of health insurance on treatment for opioid use disorders: Evidence from the Affordable Care Act Medicaid expansion," Journal of Health Economics, Elsevier, vol. 60(C), pages 177-197.
    17. David Cho & Daniel I. García & Joshua Montes & Alison E. Weingarden, 2021. "Labor Market Effects of the Oxycodone-Heroin Epidemic," Finance and Economics Discussion Series 2021-025, Board of Governors of the Federal Reserve System (U.S.).
    18. Mary A. Burke & Riley Sullivan, 2020. "Medication-assisted Treatment for Opioid Use Disorder in Rhode Island: Who Gets Treatment, and Does Treatment Improve Health Outcomes?," New England Public Policy Center Research Report 20-3, Federal Reserve Bank of Boston.

    More about this item

    Keywords

    ;
    ;
    ;
    ;
    ;

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:381:y:2025:i:c:s0277953625006148. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.