Dissertation Award: The Association Between Substance Use Disorders and Firearms Suicides in North Carolina Claims Data

Overview

This study will explore the association of both substance use disorder and long-term opioid therapy with gun suicide among Medicaid-insured North Carolinians and assess whether certain mental health diagnoses—especially depression and generalized anxiety disorder—affect this association.

Grant Award: $25,000

Organization: University of North Carolina, Chapel Hill

Doctoral Student: Josie Caves, epidemiology, University of North Carolina, Chapel Hill

Expected Completion Date: June 30, 2020

Project Summary

Purpose

Explore the association of both substance use disorder and long-term opioid therapy with gun suicide among Medicaid-insured North Carolinians.

In addition, explore specific mental health diagnoses—especially depression and generalized anxiety disorder—as modifiers of the association between substance use disorder and gun suicide.

Approach

  • Link data from the North Carolina Violent Death Reporting System on gun suicide victims from 2014 to 2017 to state Medicaid claims data for 2014 to 2016.
  • Use a base cohort of a 10 percent sample of Medicaid beneficiaries to serve as controls.
  • Analyze claims data to determine incidence of substance use disorder and mental health diagnoses.
  • Explore several measures of long-term opioid use.
  • Use cox proportional hazard regression analysis to estimate risk of all-cause suicides, firearm suicides and poisoning suicides (overdoses).

Significance

This project will help families, physicians, and policymakers evaluate suicide risk and reduce suicide among people with substance use and other specific mental health diagnoses.

Doctoral Student

Josie Caves, epidemiology, University of North Carolina (UNC), Chapel Hill. Caves’s research interests include intimate partner violence, police violence, firearm violence and the opioid epidemic. She has been supported by the Raluca Iosif Intimate Partner Violence Research Award from IntraHealth International and the UNC Gillings School of Public Health’s Robert Verhalen Endowed Scholarship in Injury Prevention/Trauma Management. She has worked as a nurse at Rex Hospital in Raleigh, N.C., and as a research coordinator at Duke University and UNC hospitals.