System explores link between chronic pain, suicide


The correlation between pain and deaths, especially suicide deaths, is not well documented in the United States, according to the National Violent Death Reporting System.

That concerns Janet Schnell, substance abuse counselor for Groups Recover Together’s Jasper office and Indiana’s only certified suicidologist.

“They could only get information from eight counties about deaths by suicide as related to chronic pain,” Schnell said. “Only eight coroners (in Indiana) were identifying chronic pain associated with suicide deaths. And they recognized that 8.8% of those deaths were identified as had having chronic pain. So they realized that this was a real thing, this was a problem.”

In the United States, 10.5 million people have what is described as “considerable” pain.

“What we’re recognizing is that we are underreporting severely the association with chronic pain and suicide deaths,” Schnell said.

The National Violent Death Reporting System was put in place because it was found that in the U.S., many causes of death were being designated as “unspecified” or “undetermined.”

“That’s just saying we don’t know,” Schnell said. “The federal government was looking at that, saying that’s not acceptable.”

The reporting system is becoming more active in Indiana, but it is not yet being incorported in all counties. Dubois County doesn’t yet incorporate it, but will soon.

According to Schnell, so many people were dealing with chronic pain, and were getting opiates to handle the pain. But now that it is well known that opiates are addictive, the trend has been for medical professionals to not prescribe them as freely. However, many people are already addicted.

“For me, the cause of concern is that we have doctors who have been prescribing people opiates, not recognizing at the beginning that there was an addiction,” Schnell said. “Now the federal government comes out, and we all recognize there is an opiates addiction. And the response has been to cut people off of all opiates, leaving people who truly have chronic pain, perceived or real, with having that extreme pain and not knowing what to do.

“That’s where we’re seeing the increase in suicide deaths. It’s that hopelessness.”

Several organizations are trying to help people handle the addiction, including Groups Recover Together. Schnell, who is well known in Dubois County for her advocacy for addressing the problems that cause and the impacts of suicide, joined the Jasper office a month ago.

“We still have that mentality here that you choose to be an addict; you choose to have the addiction problem,” she said. “People don’t actually realize there are professionals out in the community that can help with the addiction. So they struggle. They don’t have the doctor no longer prescribing them, so they buy them illegally.”

Morgan Frederick, Groups Recover Together’s regional manager of southeastern Indiana, agreed.

“People may have had a surgery that required oxycodone or hydrocodone, and suddenly that’s yanked out of their hands because the time is up. But now their body is addicted to this medication,” she said. “The next step is to find something off the street, which is typically heroin.”

And that illegal drug is not hard to find, especially locally, said Cheri Messmer, office coordinator for Groups Recover Together’s Jasper office. “It’s easily accessible. It’s much cheaper, many times, than prescription medication.”

Groups Recover Together uses two different types of group therapy programs: cognitive behavioral therapy and dialectical behavioral therapy. Cognitive behavioral therapy teaches group members to find connections between their thoughts, feelings and actions and increase awareness of how these things impact recovery. Dialectical behavioral therapy teaches them how to cope healthily with stress, regulate emotions and improve relationships with others.

The organization also incorporates medication management, which includes prescribing suboxone, a medication that people typically use for 18 to 24 months.

“My concern is that in this community, people don’t understand medication management,” Schnell said. “When I talk about this with group members, I use diabetes as an example, because I have diabetes. Yeah, I could have changed my eating habits. But that doesn’t take out the genetic component. I need medication to help manage my diabetes, along with better eating habits.

“It’s the same thing for people with addictions,” she continued. “You have to have a variety of approaches when it comes to people with addictions. One program doesn’t fit all.”

Groups Recover Together uses evidence-based programs that are recognized and encouraged by the Substance Abuse and Mental Health Services Administration, an agency within the U.S. Department of Health and Human Services.

The Groups Recover Together Jasper office can be reached at 812-558-0574 or

Help for anyone feeling suicidal or depressed is available by calling 800-SUICIDE.

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