Using Mindfulness-Based Cognitive Therapy to Prevent Suicide Among High Suicide–Risk Patients Who Also Misuse Opioids: a Preliminary Probe of Feasibility and Effectiveness

Megan S. Chesin, Chintan V. Dave, Catherine Myers, Barbara Stanley, Anna Kline, Maureen Monahan, Miriam Latorre, Lauren M.St Hill, Rachael B. Miller, Arlene R. King, Dianna R. Boschulte, Megan Sedita, Alejandro Interian

Published Year: 04/19/2022

Abstract: Knowledge of how to effectively prevent suicide attempt (SA) in high suicide–risk patients who also misuse opioids is limited. In a subset of data from 36 participants with baseline opioid misuse in a randomized clinical trial testing adjunctive mindfulness-based cognitive therapy to prevent suicide among high suicide–risk veterans (n = 18 per treatment condition), MBCT-S reduced the likelihood of SA and acute psychiatric hospitalization over 12-month follow-up. Those in MBCT-S had a relative risk of 17% and 42% for SA and hospitalization (p =.09,.02), respectively, compared to those receiving enhanced treatment as usual (eTAU) alone. Rates of opioid misuse during follow-up were more than halved with the addition of MBCT-S to eTAU (p =.08). Meanwhile, among trial participants who did not misuse opioids (n = 104), RRs of 64% and 77% for SA and hospitalization (p =.28,.33), respectively, were found with MBCT-S compared to eTAU. An MBCT-S trial with greater power is warranted in this population.