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The Role of Opiates in Social Pain and Suicidal Behavior

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Behavioral Neurobiology of Suicide and Self Harm

Part of the book series: Current Topics in Behavioral Neurosciences ((CTBN,volume 46))

Abstract

With more than 800,000 deaths by suicide each year and 20 to 30 times more suicide attempts worldwide, suicide is a major public health problem. Current treatments of SB are mainly based on pharmacological treatments that are not specific of SB (e.g. antidepressants), and new therapeutic targets are urgently needed. Recent data strengthen the ancient conception pain (social, psychic, physical) that is at the core of the suicidal process and should be incorporated in the clinical assessment of suicide risk. Then, the mechanisms involved in the regulation of pain may open new avenues regarding therapeutic perspectives. Opiates appear to be a promising candidate in treatment of SB. Indeed, since the last two decades, growing evidences suggest an implication of the opioid system in the pathophysiology of SB, this conduct to the elaboration of randomized controlled trials (RCTs) using opiates in patients with SB. Results suggesting an anti-suicidal effect of buprenorphine and the potential opioidergic-related anti-suicidal effect of ketamine both contribute to the growing interest in opiates use in SB. In this review, we will summarize a large part of the evidence that leads researchers and clinicians to be interested in the use of opiates for SB treatment and discuss on new opioid pharmacological options for suicidal patients.

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Authors and Affiliations

  1. Department of Emergency Psychiatry and Acute Care, CHU, Montpellier, France

    Benedicte Nobile, Emilie Olie & Philippe Courtet

  2. PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France

    Benedicte Nobile, Emilie Olie & Philippe Courtet

  3. University Montpellier, Montpellier, France

    Benedicte Nobile, Emilie Olie & Philippe Courtet

  4. Centre National de la Recherche Scientifique, Université de Strasbourg, Institut des Neurosciences Cellulaires et Intégratives, Strasbourg, France

    Pierre-Eric Lutz

  5. Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France

    Pierre-Eric Lutz

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  1. Benedicte Nobile
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  2. Pierre-Eric Lutz
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  3. Emilie Olie
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  4. Philippe Courtet
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Correspondence to Philippe Courtet .

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  1. Fundacion Jimenez Diaz Psychiatry Department, Universidad Autonoma de Madrid, Madrid, Spain

    Enrique Baca-Garcia

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Nobile, B., Lutz, PE., Olie, E., Courtet, P. (2020). The Role of Opiates in Social Pain and Suicidal Behavior. In: Baca-Garcia, E. (eds) Behavioral Neurobiology of Suicide and Self Harm. Current Topics in Behavioral Neurosciences, vol 46. Springer, Cham. https://doi.org/10.1007/7854_2020_167

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