Drug Overdose and Suicide Among Veteran Enrollees in the VHA: Comparison Among Local, Regional, and National Data.

Background Suicide is the 10th leading cause of death in the US, primarily from drug overdose. In 2017, 67.8% of drug overdoses were with prescription opioids. The rate of opioid use disorder among patients in the Veterans Health Administration (VHA) is 7 times higher than that of non-VHA enrollees. This study compares the incidence of overdose and suicide across facility, regional, and national levels in the VHA system in the context of a multispecialty opioid risk reduction program at the North Florida/South Georgia Veteran Health System (NF/SGVHS). Methods This retrospective study used fiscal years 2012 to 2016 overdose and suicide aggregate data from the US Department of Veterans Affairs (VA) Support Service Center medical diagnosis cube and VA Suicide Prevention Program. Overdose data were aggregated by facility and fiscal year, and overdose rates (per 1,000 individuals) were calculated. Results The average annual rate of overdose diagnosis at NF/SGVHS during the study period was slightly higher (16.8 per 1,000) compared with its region (16.0 per 1,000), and VHA national (15.3 per 1,000) rates. The NF/SGVHS had the lowest average annual rate of suicide (9.1 per 100,000) during the study period, which was one-quarter of the VHA national rate. Conclusions NF/SGVHS developed and implemented a biopsychosocial model of pain treatment that includes primary care integrated with mental health and addiction services. The presence of this program during a period when the facility was tapering opioid prescriptions could explain the relative reduced suicide rate.