The review of suicide notes provided by Petrosky and colleagues highlights that more than two thirds of suicide decedents with a pain condition mentioned their pain, as well as longstanding suffering from this pain, as a direct contributor to the suicidal crisis. This observation highlights the need to improve pain treatment, not only for the direct effect on pain and functioning but also as a method to raise hope in persons with chronic pain.
Petrosky and colleagues' work underscores that suicide may be a potentially lethal consequence of suffering in patients with pain. Suicide prevention involves making effective pain interventions more available, which extends beyond providing access to opioids and should also include, if appropriate, other medications, interventional programs, physical therapy, and psychosocial approaches (8). These pain-related interventions need to be supplemented with mental health treatment in persons with pain and depressive and anxiety-related symptoms to foster hope and help address suicidal thoughts and plans.