Suicide is a leading cause of death in the United States and the world. According to the Centers for Disease Control and Prevention (CDC), suicide claimed the lives of 47,000 people. This is the highest it has been in at least 50 years according to government records. It was the second leading cause of death among individuals ages 10-34, and the fourth leading cause of death among individuals ages 35-54. There were more than twice as many suicides as there were homicides. Worldwide, suicides account for over 800,000 deaths annually, or about 1 suicide every 40 seconds. Per the National Institute of Mental Health, the total suicide rate has increased 31% from 2001 to 2017. The suicide rate for males remains four times higher than among females.
In addition to the significant emotional aspect felt by family members and friends, suicide has a heavy financial toll in society as well. Suicide accounted for nearly $51 billion in 2013 per a CDC report. Accidental deaths account for the number 1 reason of death in adolescents and young adults. Drug overdoses are the biggest culprit, whether suicide or accidentally, which killed more than 66,000 people in the USA in 2017. This was a 16% increase from the previous year. To give a better idea of how significant number this is, it’s over 1.5x more common to die from a drug overdose than it is from a motor vehicle accident or firearm-related death.
The opiate epidemic is a major factor for the number of deaths. Poor medical decision-making, lack of treatment options, easy availability, and the lucrative second hand market all contributed to this. Per the AMA Opioid Task Force report 2019, there has been a 33% drop in national opiate prescriptions between 2013 and 2018. The CDC Guidelines for Prescribing Opiates for Chronic Pain have certainly helped decrease the number of prescription related overdoses.
The CDC has said life expectancy has gone down due to more Americans dying younger due to suicides and drug overdoses. As I mentioned above, 2017 had the most number of suicides in the last 50 years- but why? Dr. William Dietz, a disease prevention expert at George Washington University, sees a sense of hopelessness. Financial struggles, increasing disparity in the income gap, poor coping mechanisms can lead to increased drug use, which can potentially lead to suicide.
There are various methods to get help for individuals who feel suicidal. 1-800-273-8255 is the national suicide prevention lifeline. Psychiatric support is mandatory as well, but is there any other treatment option? Ketamine, typically an anesthetic drug used to induce people to “sleep” has been shown to be a highly efficacious treatment option for those with acute or chronic suicidal ideations. A series of 6 ketamine infusions over 2-3 weeks can make a significant difference and treat underlying depression as well. Under the vigilant watch of an anesthesiologist, this is a safe and promising treatment. A study conducted at Mount Sinai Medical Center in New York that was a randomized clinical trial had 24 participants, that were placed in a group receiving ketamine and a group receiving midazolam. Midazolam, of note, is a benzodiazepine with anxiolytic properties. The results were impressive, in that the group that received ketamine showed significantly lower suicidal ideations than the control treatment of midazolam. This was confirmed objectively by lower MADRS-SI scores (a measurement tool for depression and suicidal ideation). The study’s conclusion was that ketamine may have a major impact saving lives by disrupting the suicidal crisis.
RevIVe Wellness has blogged about workplace burnout before. I see a number of patients on a daily basis who have low job satisfaction due to increasing responsibilities, poor administrative direction, lack of sleep and exercise, and bringing home related stress to work. We have seen our own medical colleagues sadly take their lives. Post traumatic stress disorder (PTSD), depression, and burnout is quite prevalent in the military and police and fire departments as well. Just last week, 2 NYC policemen committed suicide within 24 hours. The NYC police commissioner, James P. O’Neill, delivered a powerful message to the entire force of 36,000 officers and 19,000 employees:
“We are mourning the death of two members of our NYPD family this week, both of whom died by suicide in separate incidents less than 24 hours apart.
Whether you are depressed, going through a separation, having financial difficulties, feeling anxiety, or anything else, you are never alone. Nothing is ever hopeless.
We cannot hide from this incredibly important discussion. We must not pretend that these things don’t happen, or that such tragic deaths are somehow a fact of life. Importantly, we cannot sit idly by and just pray that they don’t happen again. We have to take action now. We have to discuss mental health.
Each of us is dedicated to the important business of fighting crime and keeping New Yorkers safe. And this is an immensely tough job. But your personal life can be even tougher. You may have no idea your office coworker — or your sector partner, even — is dealing with a challenge for which they see no positive resolution.
But you need to know, and always remember: What seems unbearable today, absolutely will be more manageable tomorrow. The first step toward a solution is speaking to someone. And if you’re worried about a friend or colleague, you can make a confidential referral to our Employee Assistance Unit on their behalf.
This is about keeping our family healthy — and about saving lives. Your jobs require that you spend so much of your work day helping people in crisis. But, before you can take care of others, it’s imperative that you first take care of yourselves.
Seeking help is never a sign of weakness — it’s a sign of great strength. Trained members will listen and connect you with even more help, around the clock. I implore you to seek out — or to help others find — the assistance that is so readily available to us all.
Thank you for what you do every day and, please, always stay safe.”
James P. O’Neill
“You are never alone.” This is a powerful message for all of us.