Could Buprenorphine Help Reduce Suicidal Thoughts?


Buprenorphine is most commonly known as a treatment for opioid addiction. However, this active ingredient in Suboxone could also be an effective tool in decreasing suicidal ideation.

That’s according to the findings in a recent study published in the American Journal of Psychiatry. Israeli scientists recruited study participants from hospitals throughout the country, 57% of whom met the criteria for borderline personality disorder. They were either given a placebo or small doses of buprenorphine, and had their suicidality measured throughout the trial.

Most of the study participants, patients recruited from Israeli hospitals, had attempted suicide in the past, and 57% met criteria for borderline personality disorder. They were given small doses of either buprenorphine or a placebo, and researchers measured their suicidality throughout the trial.

Patients who received buprenorphine reported a marked decrease in suicidal thinking compared with those who received the placebo. But Anne Skomorowsky, a psychiatrist at the Icahn School of Medicine at Mount Sinai in New York, noted that “perhaps the study’s most important contribution is its implication that treatments that help us withstand mental pain may prevent suicide.”

Skomorowsky gives context to this notion by citing psychologist Edwin Shneidman, who in 1993 introduced the idea that depression and suicidality are separate conditions; for example, treating depression does not necessarily decrease suicidality. Shneidman said, “Feeling guilty or depressed … does not make one suicidal, unless it causes unbearable psychological pain.”

Buprenorphine is a semi-synthetic opioid that’s used to relieve the painful withdrawal symptoms of opioid addiction. Buprenorphine was used in the study—as opposed to stronger opioids like oxycodone or hydrocodone that’s found in drugs like OxyContin and Vicodin—because it’s able to stimulate some but not all of the brain’s opioid receptors, allowing it to relieve pain without the same level of euphoria, Skomorowsky writes.

The Israeli researchers raise the potential of a drug that targets suicidality specifically, presenting an alternative approach to helping patients with suicidal thoughts, says Skomorowsky.

Traditionally, therapists try to “increase tolerance” by trying to identify and address the source of a patient’s mental pain. By using buprenorphine, a patient would be helped to “decrease pain”—not just physical, but mental as well.

This study’s findings, and new research that suggests mental and physical pain are processed the same way in the brain, could change the way we address suicide prevention.