Can Buprenorphine Help Reduce Suicidal Thoughts?

By Victoria Kim 02/24/17

In a new study, Israeli researchers investigated whether mental pain could be successfully treated like physical pain. 

Image: 
Sad woman looking through car window.

Buprenorphine (the active ingredient in Suboxone) is not only effective for the treatment of opioid addiction, but for decreasing suicidal ideation—that’s according to Israeli scientists who made the discovery in a 2015 study found in the American Journal of Psychiatry.

Anne Skomorowsky, a psychiatrist at the Icahn School of Medicine at Mount Sinai in New York City, recently wrote about the study in the Scientific American

The research team sought to emulate the brain’s naturally-occurring endogenous opioids with buprenorphine. These “help us feel good when we are with loved ones,” Skomorowsky explains. “Mental pain” or separation distress occurs when we separate from loved ones, causing our natural opioid levels to drop.

Most of the study participants, patients recruited from Israeli hospitals, had attempted suicide in the past, and 57% met criteria for borderline personality disorder. They were given small doses of either buprenorphine or a placebo, and researchers measured their suicidality throughout the trial.

The result was a significant decrease in suicidal thinking among patients who received buprenorphine compared with the placebo. But, as Skomorowsky notes, “Perhaps the study’s most important contribution is its implication that treatments that help us withstand mental pain may prevent suicide.”

Skomorowsky gives context to this notion by citing psychologist Edwin Shneidman, who in 1993 introduced the idea that depression and suicidality are separate conditions; for example, treating depression does not necessarily decrease suicidality. Shneidman said, “Feeling guilty or depressed … does not make one suicidal, unless it causes unbearable psychological pain.”

Buprenorphine is a semi-synthetic opioid that’s used to relieve the painful withdrawal symptoms of opioid addiction. Buprenorphine was used in the study—as opposed to stronger opioids like oxycodone or hydrocodone that’s found in drugs like OxyContin and Vicodin—because it’s able to stimulate some but not all of the brain’s opioid receptors, allowing it to relieve pain without the same level of euphoria, Skomorowsky writes. 

The Israeli researchers raise the potential of a drug that targets suicidality specifically, presenting an alternative approach to helping patients with suicidal thoughts, says Skomorowsky. 

Traditionally, therapists try to “increase tolerance” by trying to identify and address the source of a patient’s mental pain. By using buprenorphine, a patient would be helped to “decrease pain”—not just physical, but mental as well.

This study's findings, and new research that suggests mental and physical pain are processed the same way in the brain, could change the way we address suicide prevention.

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Victoria is interested in anything that has to do with how mind-altering substances impact society. Find Victoria on LinkedIn or Tumblr

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