WASHINGTON As fatal opioid overdoses continue to rise , the causes of each death have become all too familiar: They usually involve a lethal cocktail of heroin, painkillers, and increasingly, the powerful synthetic opioid Fentanyl. But often left out of these tragic stories is the inner turmoil going on inside each victim, and researchers have started examining trauma and depression as well as social connectedness as possible factors in the rise of overdoses.

In addition to the spread of painkillers and cheap heroin, some fatal overdoses may in fact be suicides. Dr. Joshua Gordon, the director of the National Institute of Mental Health , believes that there may be a stronger link between the opioid epidemic and suicide than previously realized.

There are, of course, links between addictions in general and opioid addictions in particular and suicide, Gordon told HuffPost. There is a lot of concern that many of the overdose deaths could be suicides. We need to learn more about the prevalence of suicidality amongst opioid addicted individuals.

Many of the same drivers behind suicidal thinking can be found in those addicted to opioids, from feelings of isolation and despair to economic anxieties and histories of trauma.

A recent Scientific American piece written by journalist Maia Szalavitz noted the connections between the rise in unemployment and overdose deaths, while a recent study her article highlighted showed how counties with low social connectedness suffered the highest fatal overdose rates.

Even before the opioid epidemic made national headlines, research warned about the connection between suicidal urges and drug use. A study published in 2004 found an elevated risk for suicide among intravenous drug users. The researchers noted also that the suicide risk was greater than that found among alcoholics.

In past interviews with those addicted to opioids , it was not uncommon to find sufferers who talked about intentionally overdosing or engaging in risky behavior, knowing that it might lead to an overdose. Depression and suicidal thinking were common and failure to sustain a lasting recovery could compound those feelings.

Gordon said he would like to see more data collected that examines the connection between suicidal behavior and overdoses.

One thing is the geographic distributions of overdoses and suicides in terms of rates in the general population, they look kind of similar I have to say, Gordon said. Its sort of shocking the degree of overlap. One begins to wonder, well, what are the causes of the increases in suicide rates, the increases in overdose rates? And what are the societal causes that might be contributing to those.

Along with isolation and anxiety, Gordon said there were other commonalities between people that are suicidal and those addicted to opioids. These might include issues dealing with chronic pain management and unemployment, he said, adding that the addiction itself could contribute to a persons suicidal urges.

There could be direct causal links between the two, he said.