Alexandre Mikhail1, Omaid Tanoli1, Gilles Légaré2, Pierre-André Dubé3, Youssef Habel4, Alain Lesage5, Nancy C P Low4,6,7, Suzanne Lamarre8, Santokh Singh8, Elham Rahme1,4. 1. 1 Department of Medicine, McGill University, Montreal, QC, Canada. 2. 2 Bureau d'information et d'analyse en santé des populations, Institut National de Santé Publique du Québec, QC, Canada. 3. 3 Direction de la santé environnementale et de la toxicologie, Institut National de Santé Publique du Québec, QC, Canada. 4. 4 Research Institute of the McGill University Health Centre, Montreal, QC, Canada. 5. 5 Départment de Psychiatrie, Université de Montréal, QC, Canada. 6. 6 Department of Psychiatry, McGill University Health Centre, Montreal, QC, Canada. 7. 7 Mental Health Service, Services for Students, McGill University, Montreal, QC, Canada. 8. 8 Department of Psychiatry, St-Mary's Hospital, Montreal, QC, Canada.
Abstract
Background: Over-the-counter (OTC) analgesics are frequently used in suicide attempts. Accessibility, toxicity, and unsupervised acquisition of large amounts may be facilitators. Aims: To identify patient characteristics associated with OTC drug use as a suicide attempt method among adults. Method: A cross-sectional study was conducted using chart review of all individuals who presented to the emergency department (ED) of two adult general hospitals following a suicide attempt during 2009-2010 in Montreal, Canada. Results: Among the 369 suicide attempters identified, 181 used overdosing, 47% of whom used OTC drugs. In logistic regression, women and those with medical comorbidity were more likely to use overdosing, while those with substance use disorders were less likely to do so. Among those who overdosed, women were more likely to use OTC drugs, while those who were Caucasian, had children, comorbidities, diagnoses with substance use disorders, and made attempts in the Fall were less likely to do so. Substances most frequently used were: acetaminophen among OTC drugs (30%); antidepressants (37%), anxiolytics (30%), opioids (10%), and anticonvulsants (9%) among prescription drugs; and cocaine (10%) among recreational drugs. Limitations: Reasons for the suicide method choice were not available. Conclusion: OTC drugs, in particular acetaminophen, are frequently used in suicide attempts. Accessibility to these drugs may be an important contributor.
Background: Over-the-counter (OTC) analgesics are frequently used in suicide attempts. Accessibility, toxicity, and unsupervised acquisition of large amounts may be facilitators. Aims: To identify patient characteristics associated with OTC drug use as a suicide attempt method among adults. Method: A cross-sectional study was conducted using chart review of all individuals who presented to the emergency department (ED) of two adult general hospitals following a suicide attempt during 2009-2010 in Montreal, Canada. Results: Among the 369 suicide attempters identified, 181 used overdosing, 47% of whom used OTC drugs. In logistic regression, women and those with medical comorbidity were more likely to use overdosing, while those with substance use disorders were less likely to do so. Among those who overdosed, women were more likely to use OTC drugs, while those who were Caucasian, had children, comorbidities, diagnoses with substance use disorders, and made attempts in the Fall were less likely to do so. Substances most frequently used were: acetaminophen among OTC drugs (30%); antidepressants (37%), anxiolytics (30%), opioids (10%), and anticonvulsants (9%) among prescription drugs; and cocaine (10%) among recreational drugs. Limitations: Reasons for the suicide method choice were not available. Conclusion: OTC drugs, in particular acetaminophen, are frequently used in suicide attempts. Accessibility to these drugs may be an important contributor.
Authors: Natalia Piotrowska; Jolanta Klukowska-Rötzler; Beat Lehmann; Gert Krummrey; Manuel Haschke; Aristomenis K Exadaktylos; Evangelia Liakoni Journal: Emerg Med Int Date: 2019-12-06 Impact factor: 1.112