Longitudinal Correlates of Suicide Ideation in People who use Drugs during the COVID-19 Pandemic

Abstract Some individuals may be more vulnerable to increased suicide-related thoughts and behavior in response to the COVID-19 pandemic but few studies have investigated risk factors that may be more predictive/specific to particular populations that are established to have a high risk for suicide, including gender differences in risk factors. We conducted a longitudinal study investigating risk factors for suicide ideation during the COVID-19 pandemic in adults who use alcohol and other drugs. Participants completed up to three surveys over a six-month follow-up period. Trait differences in substance use, COVID exposure/worry, trauma exposure, mood and post-traumatic stress disorder symptoms were investigated between individuals who presented with suicide ideation during course of study, compared to those that did not. Interactions with gender was investigated. State-related changes that relate to fluctuations in suicide ideation were also investigated (within subject design). A total of 214 participants were enrolled (61% women, agemean= 33 years, 45% presenting with suicide ideation during the course of the study). Greater frequency of vaping and using tobacco, opiates, and other substances, greater depression, anxiety, and PTSD symptoms, and greater COVID exposure and COVID-related worry were observed in individuals who presented with suicide ideation, compared to those that did not (p ≤ .0042). Increases in suicide ideation (within subject) was associated with increases in the frequency of alcohol and vaping, COVID-related worry, and PTSD symptoms (p ≤ .05). Gender-related differences in factors that relate to suicide ideation was observed. Within women, increases in frequency of alcohol use and PTSD symptoms and greater perceived early life trauma related to suicide ideation; while in men increases in vaping and COVID-related worry related to suicide ideation. This study further emphasizes the importance of investigating and identifying risk/resiliency factors for suicide-related thoughts and behavior in people who use drugs, including gender differences.