Suicide verdicts as opposed to accidental deaths in substance-related fatalities (UK, 2001–2007)

Background : Substance-related deaths account for a great number of suicides. Aim : To investigate levels and characteristics of suicide verdicts, as opposed to accidental deaths, in substance misusers. Methods : Psychological autopsy study of cases from the UK National Programme on Substance Abuse Deaths (np-SAD) during the period 2001–2007. Results : Between January 2001 and December 2007, 2108 suicides were reported to the np-SAD. Typical suicide victims were White and older than 50 (respectively 95% and 41% of cases). Medications, especially antidepressants (44%), were prescribed to 87% of victims. Significantly fewer suicide victims than controls presented positive blood toxicological results for illicit drugs (namely: cocaine, heroin, amphetamines, ecstasy-type drugs, cannabis, and GHB/GBL) and alcohol. Conclusions : Suicide prevention programmes should devote specific attention to deaths among substance misusers who are at high risk of fatal intentional self-harm. Specific characteristics distinguish those at risk; caregivers should be better educated as to what these factors are. Limitations of the current study included lack of provision of comprehensive information relating to the victims' psychosocial variables. Furthermore, no differentiation between different classes of antidepressants in terms of involvement in suicide was here provided. Research highlights : Suicide among drug-related deaths can be characterised through a number of variables when compared with other causes of death. Suicide among drug-related deaths were more economically disadvantaged and had more medical problems. Suicides among these deaths were positive at blood toxicological tests for psychotropic drugs, and fewer suicide victims than controls had positive blood toxicological results for illicit drugs, alcohol, and methadone.