Meet our Study Advisor, Suicide Scholar Dr. Thomas Joiner

Dr. Thomas Joiner is a leading national expert on suicide. He is also a chaired professor at Florida State University. He has written several books and hundreds of scientific articles on suicide, and he is a key advisor to the CSI:OPIOIDs study. He also has developed an important theory that helps us begin to think about why people take their lives. Our principal investigator, Dr. Stefan Kertesz, recently spoke with Dr. Thomas Joiner. Read more below.

Q: Dr. Joiner, can you tell us where you grew up and why you became a psychologist?

A: I was born and raised in Atlanta. I was initially drawn to philosophy but grew frustrated with the abundance of questions and the lack of answers. I noticed the psychologists were asking the same kinds of questions and then empirically arbitrating them. I thought that was very appealing. As for why a clinical psychologist, I just thought and still think that psychopathology is inherently fascinating. It is also a major source of human suffering and so trying to contribute to the reduction of suffering is also appealing to me.

Q: What has led you to put your effort into suicide prevention?

A: Initially it was the intellectual interest in philosophical questions having to do with existence, the lack of it, meaning, and the lack of it as well. Then, it became deeply personal and urgent when my dad took his own life when I was in graduate school.

Q: Our team sought for advice when we were just getting started. Why did you decide to advise the CSI:OPIOIDs project?

A: I’m interested in virtually any effort that has suicide prevention potential as this effort plainly does.


Q: There’s a theory about why people sometimes take their own lives. It’s credited to you. In simple terms, the theory says that people are more likely die by suicide when a few different things happen together. Two of those things have to do with how they feel in relationship to others. One has to do with feeling alone, and the other with felling like a burden. Can you tell us more about what those mean?

A: I believe the two main pillars of human nature are autonomy/agency and inter-dependence/connection. These also account for things like meaning. If those are undermined–as they are when people feel that they do not belong and that they burden others–reasons for living, meaning, and purpose are reduced.

Q: People talk about a theories in different ways. Sometimes they mean “it’s proven reality” like Einstein’s “Theory of Relativity”. Sometimes they mean, “this is an idea we are still developing and trying to document”. Which kind of theory is this?

A: I’m with the philosopher of science Karl Popper that there generally is no “proven” category. The only categories are “false” and “not false…yet”.  But a problem with Popper’s philosophy, one that he recognized, is that falsifications can be spurious, and so the judgment is difficult. As for my theory, I would use terms like “useful, including clinically “and “explanatory, at least partially.” There is a considerable empirical basis behind it, though it is unsurprisingly imperfect.

Q: Our study looks at a difficult event that happens in US health care where a person with pain loses access to pain medication. Some people do wind up taking their own lives and others don’t. What do you think are important questions for us to ask as we go forward?

A: I think an important point is that people can adapt to all sorts of things if they’re just given time and support. Exploring ways to disseminate that view seems like a potentially significant contribution to me.


Q: Many of us who work with the study know people who have lost someone to suicide, and we don’t always know what to say when we aren’t wearing our research hats. How can we be helpful to families and friends who have lost someone?

A: People can lose sight of the fact that the word “death” is of course an important part of the term “death by suicide.” It is a death, like a cardiac death or a car accident, and people should be guided in their reactions by remembering that.

CSI:OPIOIDs Team speaks to United Suicide Survivors International

Our CSI:OPIOIDs research team was honored to present and learn from United Survivors (United Suicide Survivors International) and its chair Sally Spencer-Thomas, PsD, a leader and advocate in the prevention of suicide.

This evening was made unique by powerful observations from both Mark Flower and Jim Elliott. Mark is an advocate and Veteran who is in recovery and has lost friends suicide. Jim lost his brother Danny to suicide in November, 2022, after a physician’s office was closed down.

This presentation introduces why it’s so important to collect the stories of these losses. Powerful reflection from Jim and Mark begin at 13:50. View the discussion on Facebook here.

CSI:OPIOIDs team presents to the renowned RxSummit!

Members of our study team shared the CSI:OPIOIDs study design and “early insights” at the renowned Rx and Illicit Drug Summit in Atlanta on April 1, 2024. The Summit draws on policymakers, patients, and clinicians. Competition to present is steep. Our presentation will focus primarily on insights learned through recruitment and outreach to the community of people living with pain and survival after suicide loss. 

New commentary on Pain News Network

Today, the well-read Pain News Network website published “Why We Need to Study Suicides After Opioid Tapering”, a column by study investigator Dr. Stefan G. Kertesz. “Prescription opioid reductions are not always good, and not always bad,” writes Dr. Kertesz, but he then lays out why it’s important to study the suicides that have happened, and how people can spread the word. Check it out online here.

Dr. Kertesz and Dr. Varley speak at Reflex Sympathetic Dystrophy Syndrome Association (RSDSA) Conference

Dr. Kertesz and Dr. Varley discuss Understanding Suicides after Prescription Opioids are Stopped: The CSI:OPIOIDs Research Study with the Reflex Sympathetic Dystrophy Syndrome Association (RSDSA). You can view the presentation on FaceBook and YouTube here. Both investigators are behind the world’s only study to directly examine suicides that happen after prescription opioid reduction or stoppage. Their presentation introduces why this study needs to be done, how it is being done, and how people from the pain and RSDSA communities could join the effort.

CSI:OPIOIDs team speaks to 988 Crisis Line learning community

On August 16, 2023, CSI:OPIOIDs team members Stefan Kertesz (lead investigator), Kate Nicholson (National Pain Advocacy Center) and Thomas Joiner (Florida State University) discussed CSI:OPIOIDs for an audience of over 300 people working to improve the 988 Crisis Lifeline response. You can watch the video below and check out slides from Dr. Kertesz by clicking here.

Dr. Kertesz to speak at Yale Addiction Medicine Grand Rounds

Dr. Stefan Kertesz will speak to the Yale Program in the Addiction Medicine Grand Rounds about our study on Tuesday July 25, 2023 at 11am (CT) in a talk titled “Studying Suicides after Prescription Opioids are Stopped: Let’s Move Beyond Statistics with the CSI:OPIOIDs Research Study”.

Registration is free and open to the public for this online presentation. Link to register here.