The Relationship between Suicide and Opioid Abuse

In this online presentation, the third in the ICRC-S 2018 webinar series, Lisham Ashrafioun PhD, of the Department of Psychiatry at the University of Rochester Medical Center and the Center of Excellence for Suicide Prevention at the Canandaigua VA Medical Center, discussed research on the interaction between pain and substance use, how this association may influence patients’ experience of pain, substance use behaviors, and suicide risk, and the development of interventions to identify and treat patients at high-risk of pain and substance use disorders. During this presentation, Dr. Ashrafioun reviewed the epidemiological data exploring the relationship between opioid use and suicidal thoughts and behaviors, the opportunity for future research on preventing suicide among individuals using opioids, and discussed how this research can – and is – informing clinical practice and healthcare policy to avert the role of opioid-related factors in suicidal thoughts and behaviors. Dr. Katie Marks, PhD, of the Department for Behavioral Health, Developmental and Intellectual Disabilities and Project Director for the Kentucky Opioid Response Effort, discussed Kentucky’s strategy of using the bridge clinic model and peer support specialists within emergency departments to integrate screening and initiation of treatment for individuals recovering from an opioid overdose, and how these methods were integrated into hospital workflows.

Archived online presentation

Event Presenter(s)

Lisham Ashrafioun is Senior Instructor in the Department of Psychiatry at the University of Rochester and Research Investigator at the VA Center of Excellence for Suicide Prevention at the Canandaigua VA Medical Center. His research has spanned the distinct and overlapping areas of chronic pain, suicide prevention, and substance use – particularly opioid misuse. Dr. Ashrafioun’s research interests lie in assessing nonpharmacological pain management approaches, including combining various forms of self-management strategies, on physical functioning and vulnerability of suicide-related outcomes. Dr. Ashrafioun has also led several large-scale studies of the suicide risk of chronic pain patients from national survey and administrative medical record data, to identify innovative interventions and targets to optimize pain management and suicide prevention efforts in patients experiencing pain. Dr. Ashrafioun received his PhD in clinical psychology from Bowling Green State University, and completed his post-doctoral fellowship at the VA Center of Excellence for Suicide Prevention at the Canandaigua VA Medical Center as part of the VA’s Advanced Fellowship in Mental Illness Research and Treatment program.

Dr. Katherine Marks is the Project Director for the Kentucky Opioid Response Effort, a SAMHSA-funded federal grant to the Kentucky Cabinet for Health and Family Services, Department for Behavioral Health, Developmental and Intellectual Disabilities. As the Project Director, she is responsible for oversight, planning, and coordination to reduce opioid – related overdose rates and increase access to prevention, treatment, and recovery support. Dr. Marks is also a Research Assistant Professor in the Department of Behavioral Science at the University of Kentucky and has worked in the substance abuse research field for ten years. Her research has spanned the translation spectrum from preclinical research studying computational models of addiction to behavioral pharmacology in the human laboratory. Currently, her research focuses on women recovering from opioid use disorders, recovery of physical health, and reduced risk of HIV/HCV transmission among opioid – injecting women. Dr. Marks also teaches graduate courses in Dependency Behavior and Methods and Technologies in Clinical and Translational Science. Dr. Marks received a Bachelor’s Degree in Psychology from Murray State University, a Master’s Degree in Experimental Psychology from American University, and a doctorate in Experimental Psychology from the University of Kentucky. She also completed a Graduate Certificate in Clinical and Translational Science and has served as an ad-hoc reviewer for several journals including Drug and Alcohol Dependence, Experimental and Clinical Psychopharmacology, Translational Issues in Psychological Science, and Journal of Substance Abuse Treatment.

Understanding the Relationship between Traumatic Brain Injury and Suicide

In this webinar, Lisa Brenner PhD, of the University of Colorado, Anschutz School of Medicine and Director of the Department of Veterans Affairs Rocky Mountain Mental Illness Research, Education, and Clinical Center, discussed research on the relationship between traumatic brain injuries and suicide, how this association may influence patients’ suicidal ideation and suicide risk, and opportunities for early identification and treatment in health care settings of patients at high-risk for suicidal behavior due to a traumatic brain injury. During this presentation, Dr. Brenner reviewed epidemiological data on the prevalence of suicidal ideation and behavior among individuals – particularly veterans – with history of a traumatic brain injury, her current research on best practice interventions in primary care and community settings, and the opportunity for future research to avert suicidal thoughts and behaviors through enhanced care approaches. Participants were able to ask questions of the presenter. 

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Suicide & Bullying: Preventing Suicide through Collaborative Upstream Interventions

This was the sixth webinar of the ICRC-S 2018 webinar series. In this webinar, Marci Feldman Hertz, MS, of the Division of Analysis, Research, and Practice Integration at the Centers for Disease Control and Prevention reviewed research on the relationship between bullying and suicide. Her presentation explored youth risk and protective factors that might increase or decrease the risk for bullying involvement or suicide across several socio-ecological levels. She also reviewed specific strategies that schools and youth-serving organizations can implement to increase protective factors for youth. Particular emphasis was given to increasing school connectedness as part of a multi-tiered strategy. Patricia Agatston, PhD, LPC, Counselor and Prevention Specialist with the Cobb County School District’s Prevention/Intervention Center presented on the history of the district’s Prevention/Intervention Center as a comprehensive crisis intervention and prevention approach to student suicides. She also provided an overview of district strategies to prevent suicide and bullying through various evidence-based interventions and programs, and the role of community collaboration to support and expand school-based prevention efforts. 

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Lethal Means Safety for Suicide Prevention

Dr. Marian (Emmy) Betz, Associate Professor of Emergency Medicine, University of Colorado School of Medicine and emergency physician at the University of Colorado Hospital, draws on her experience in the emergency department and as a researcher to describe the rationale, current state of research and next steps for lethal means safety for suicide prevention.

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Measuring Fidelity in Suicide Prevention

Dr. Wendi Cross and Dr. Jennifer West, both of the University of Rochester Medical Center (URMC), review the importance of measuring fidelity of program implementation with particular emphasis on implementer fidelity.  They focus on measuring two constructs – adherence to program content and competence in the delivery of that content – for suicide prevention interventions. Dr. Cross is Associate Professor of Psychiatry and Pediatrics and Director of Observational Research and Behavioral Information Technology Lab (ORBIT) at URMC, and Education Specialist/Researcher at the VA Center of Excellence for Suicide Prevention, Canandaigua, NY. Dr. West is Associate Professor in Psychiatry and Pediatrics at URMC.

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Preventing Suicide through Social Connectedness: An Overview of What We Know About Promoting Connectedness

This was the first webinar of the ICRC-S 2018-19 webinar series, Preventing Suicide by Promoting Social Connectedness: An Overview of What We Know About Promoting Connectedness. In this webinar, Kim Van Orden, PhD, from the Center for the Study and Prevention of Suicide at the University of Rochester, discussed the state of the science on social connectedness as an intervention target to prevent suicide. She discussed current challenges faced by researchers and practitioners in suicide prevention, including how to define and measure connectedness; clarifying the role of connectedness as an intervention target (e.g., causal factor and/or buffer or protective factor); limitations of what is known about promoting connectedness; and opportunities for the field to build a portfolio of evidence-based strategies to promote connectedness. 

Research

The interpersonal theory of suicide. Van Orden, K. A., Witte, T. K., Cukrowicz, K. C., Braithwaite, S. R., Selby, E. A., & Joiner, T. E. (2010). Psychological review117(2), 575-600. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3130348/

Interested in measures to assess social connectedness? It’s best to select measures of Social Connectedness based on the population with whom you’re working. Two potential resources are:

Archived Webinar

Promoting Connectedness for Youth through Social Networks

This was the second webinar of the ICRC-S 2018-19 webinar series, Preventing Suicide by Promoting Social Connectedness: Promoting Connectedness for Youth through Social Networks and Sources of Strength. Sources of Strength is a universal suicide prevention program that builds protective factors and reduces the risk of suicide for vulnerable youth through a strengths-based focus on social connectedness and peer group norms. In this webinar, Dr. Peter Wyman, PhD, from the Center for the Study and Prevention of Suicide at the University of Rochester, reviewed research on the influence of school-based social networks to adolescent risk and protective factors for suicidal behaviors, discussed adolescent exposure to risk factors for suicide, and discussed how school-based social networks can be used to promote social connectedness and address adolescent relational needs. Dr. Wyman also reviewed research findings regarding the Sources of Strength impact on and through school-based networks. Scott LoMurray, Deputy Director, from Sources of Strength, provided an overview of Sources of Strength as an evidence-based universal upstream intervention, reviewed how diverse peer leaders and trusted adults use social connectedness as a protective factor to transform behavior and social norms at a school-wide level, and examined how the shared risk and protective factor framework and interventions like that of Sources of Strength can impact a variety of negative behaviors and outcomes. Presenters briefly reviewed replication of Sources of Strength with populations such as LGBTQ and Tribal youth, to promote social connectedness and positive group norms. 

Sources of Strength website: https://sourcesofstrength.org/

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RTI Rocky Mountain Evaluation 101 Webinar: Getting Started with Evaluation

This webinar, Getting Started with Evaluation, was hosted by Dr. Carol Runyan, Professor at Colorado School of Public Health. During this presentation, Dr. Runyan provided a foundational overview of evaluation methods, guided participants through the process of designing an evaluation, and reviewed important issues in developing research and evaluation projects in suicide prevention for the Rocky Mountain Research Training Institute.

Dr. Carol Runyan has been, since 2011, Professor at the Colorado School of Public Health and Director of the Program for Injury Prevention, Education and Research (PIPER). Dr. Runyan previously served as Director of the University of North Carolina (UNC) Injury Prevention Research Center from 1989- to 2011 and on the faculty at the UNC School of Public Health. Her research, program evaluation work and teaching has spanned numerous topics, including worker safety, traffic safety, safety at home, youth violence, child maltreatment, and suicide prevention. Honored by CDC as one of the 20 most influential leaders in the field in 20 years (2012), she also received a Distinguished Career Award from APHA (2014). Carol has an MPH from the University of Minnesota and PhD from the University of North Carolina where she completed a pre-doctoral fellowship in child and family policy, followed by a postdoctoral fellowship at Johns Hopkins University in injury epidemiology.

Surrogate Endpoints in Suicide Research.pdf

Evaluation webinar FINAL 3-13-2019.pdf

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Using Surveillance Data in Suicide Prevention

Designed for suicide prevention practitioners, Using Surveillance Data in Suicide Prevention offers an overview of common terms and concepts used in epidemiology. This one-hour podcast also provides information on how to identify and find data for suicide prevention, and explores traditional and non-traditional partners who can help in this effort. The podcast offers a real-life example on how data from Colorado’s Violent Death Reporting System has been used to guide community-based suicide prevention efforts.

Mr. Kirk Bol is the manager of Colorado’s Registries and Vital Statistics Branch at the Colorado Department of Public Health and Environment.  Here he provides strategic oversight and statistical expertise for a branch comprised of diverse public health surveillance programs, including Colorado’s vital statistics program, the Colorado Violent Death Reporting System, medical aid-in-dying reporting, and Colorado’s statewide, population-based cancer and birth defects registries.  Mr. Bol has also taught graduate-level courses in public health surveillance, research strategies and analytic methods as an adjunct instructor for the Department of Epidemiology at the Colorado School of Public Health, and currently sits on the board of directors for the National Association of Public Health Statistics and Information Systems, the national membership organization for state and territorial vital records and statistics offices. Mr. Bol received a Masters in Science in Public Health from the University of Colorado Denver and Health Sciences Center.(or is it University of Colorado School of Public Health?)

Dr. Kristen Quinlan is lead epidemiologist for the Suicide Prevention Resource Center (SPRC), where she provides recommendations to state and local prevention systems on collecting, analyzing and using existing suicide-related data and/or building needed infrastructure to improve suicide-related data collection for planning, quality improvement, and/or impact purposes.  Dr. Quinlan is also the Director of the Outreach Core for the Injury Control Research Center for Suicide Prevention (ICRC-S), where she is responsible for translating the latest suicide prevention research into practice through blog posts, newsletters, podcasts, and an annual webinar series. Dr. Quinlan received her Ph.D. in Behavioral Sciences from the University of Rhode Island.

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Additional resources:

A Comprehensive, Collaborative, Data-Informed, Integrated Approach to Suicide Prevention: The Colorado National Collaborative

This podcast will introduce listeners to the Colorado National Collaborative (CNC), an effort involving national, state, and local partners with the audacious goal of reducing suicide in Colorado 20% by 2024. It will begin with an overview of the public health approach and an example of a successful effort to reduce preventable injuries as context for applying it to suicide prevention. National resources developed by the Suicide Prevention Resource Center and the Centers for Disease Control and Prevention will be presented as fundamental to the CNC effort. The structure, approach, and logic model of the CNC will be discussed and the podcast will conclude with a moderated question and answer session.

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