History of parenting instability and lifetime suicidal behavior in people who inject drugs

Abstract Despite high rates of suicide in people who inject drugs, little is known about the risk factors for suicide related to childhood and family history in this population. We aimed to explore the relationship between the history of out-of-home care (OHC) and lifetime suicide attempts among people who inject opioids. Participants (N = 202) were current injection opioid users with at least one previous episode of opioid maintenance treatment. They were recruited into a double-blind randomized controlled trial for opioid substitution treatment. Secondary analysis of baseline data was conducted from the European Addiction Severity Index and basic demographics questionnaires. A total of 81 (40%) participants reported a history of living in OHC and 27% reported attempting suicide. Participants who reported living in OHC were more likely to report lifetime suicide attempts compared to those who did not live in OHC. History of OHC and suicidal ideation were significant risk factors for suicide attempts adjusting for depression and anxiety. Highest rates of lifetime attempts were among participants who lived in a group home, foster care, and/or psychiatric facility. Living in OHC during childhood was significantly associated with higher rates of suicide attempts in our sample. Greater efforts should be made to provide children from vulnerable families with environments where stable one-to-one relationships can be cultivated.