Suicide attempts among people who use drugs: a comparative gender-based analysis using the ANRS-Coquelicot survey in France

Abstract

Objective

There exists no national French study on suicide attempts among people who use drugs (PWUD). Our objectives are to analyze lifetime suicide attempts in that population and to compare associated risks based on gender.

Method

The ANRS-Coquelicot study (2011–2013) conducted 1718 interviews with people over 18 who have injected or snorted a drug or medication (whether or not it was prescribed) at least once in their lifetime, who speak French or Russian, and who attend harm reduction facilities and drug treatment centers in France. Through stratified multivariate analyses based on gender using a Poisson regression, we determined risk factors.

Results

Among PWUD, 39.9% had attempted suicide (n = 655), with a distribution of 58.8% (n = 188) for women and 35.0% (n = 467) for men. Experiences of overdose, depression, receiving psychiatric care, setting during adolescence, daily alcohol use, and number of substances consumed during the last month were risk factors for men. Among women, experiences of overdose, self-reported HIV positive, and daily use of benzodiazepines and cocaine were risk factors.

Conclusion

we should develop psychiatric care into health services catering specifically to PWUD. As risk factors differed based on gender, we should strive to create distinct preventive health measures adapted to different populations. Keywords: people who use drugs; lifetime suicide attempts; gender; mental health, quantitative survey

Keywords:

• People who use drugs
• gender
• mental health
• quantitative survey
• lifetime suicide attempts

Acknowledgments

The authors thank Camille Blanc for the English translation and for editing the article. The authors thank Andrainolo Ravalihasy for his support in the choice of statistical methods. The authors also thank all the people who use drugs who accepted to participate to the study and all the harm reduction facilities and drug treatment centers who welcome our team to conduct the survey. Bordeaux: le département d'addictologie de l’hôpital de Bordeaux; Le Local - La Case; le PES - LaCase; la boutique Planterose - CEID; le centre méthadone – CEID; le PES- CEID; le CSAPA Saint-Pierre; le CSAPA généraliste résidentiel de Bègles; le service d'appartements thérapeutiques – CEID. Lille: le Caarud Aides 59; le Caarud JOAO et ambulatoire – Reagir; le centre de soins Reagir Service Méthadone; la permanence d'accueil et d'orientation du centre de soins – Reagir; le centre d'hébergement d'urgence de nuit pour UD - Le Cèdre Bleu; le CSAPA le Cèdre Bleu; le service d'appartements thérapeutiques du Cèdre Bleu; la Clairière; le Point de repère ABEJ; le centre hospitalier la Fraternité; l’accueil Spiritek; le point accueil Oxygène CIPD; l’unité mobile Oxygène CIPD; l'Âtre; l’Ellipse – ADNSEA; le Relais – ADNSEA; le Relais – ADNSEA; le Prélude – ADNSEA; l’Intermezzo – ADNSEA; le Concerto – ADNSEA; Boris Vian. Strasbourg: La Robertsau - ALT - Association de lutte contre la toxicomanie; Ste Catherine - ALT - Association de lutte contre la toxicomanie; le RMA - Réseau maternité et addiction; le Fil d'Ariane; le Caarud – Espace Indépendance; le Bus - Espace indépendance; le CSAPA – Espace Indépendance. Marseille: AMPTA - CSAPA Ouest Etang de Berre; le CSAPA – Villa Floreal; le CSAPA Casanova - SOS drogue international; TIPI; TIPI Vian; Asud; Point Marseille, SOS DI Point Marseille; Sleep In - Consultation - SOS DI; Sleep In - Nuit - SOS DI; La Corniche - SOS DI; CSAPA Bus méthadone - Association Bus 31/32; CSAPA PES (Accueil + Bus 31/32); Accueil MDM - Association Bus 31/32; Protox; CSAPA Nationale – AMPTA; Hébergement CSAPA Nationale – AMPTA; Hébergement CSAPA Nationale – AMPTA; Puget Corderie/Pôle addictions. Paris: 110 - Les Halles - SOS drogue international (CSAPA); Le Kaléidoscope - SOS drogue international (Caarud); Emergence Espace Tolbiac CSAPA; Cité le village - Association des cités du Secours catholique; Hôpital Sainte-Anne (service d'addictologie) - Moreau de Tours; Hôpital Marmottan (CSAPA) - Addictologie; Hôpital Marmottan (service hospitalier); Hôpital Marmottan - Médecine générale; Cassini (CSAPA) - Le Centre méthadone; Le Centre Cassini CSAPA; La terrasse (Caarud) - Boréal; La terrasse (Caarud) - Équipe de rue de Boréal; La terrasse (CSAPA) - Casat La terrasse; le Centre méthadone La terrasse (CSAPA); La corde raide- Centre de soins (CSAPA); La corde raide (CSAPA) - Unité médicale; le Bus Gaïa (CSAPA); Gaïa (Caarud); Adaje (CSAPA); EGO (CSAPA); Ego Centre d'accueil (Caarud); Ego Step (Caarud); Ego – Equipe mobile Step; Safe; Monté Cristo Hôpital Marmottan Cristo (CSAPA); Nova dona (CSAPA); Nova dona (Caarud); Pierre Nicole - Unité de substitution (CSAPA); Pierre Nicole – CTR; ATR Pierre Nicole; Pierre Nicole - Pass' justice; Sleep-in - SOS drogue international (CSAPA); Sleep-in jour - SOS drogue international (CSAPA); Confluences - appartements thérapeutiques SOS drogue international (CSAPA); Confluences - Service accueil - SOS drogue international (CSAPA); Coordination thérapeutique – SOS drogue international (H); CSAPA Charonne (75013); CHS (centre d’hébergement de stabilisation) Charonne; ACT (appartements de coordination thérapeutique) Charonne; ATR (appartements thérapeutiques relais) – Charonne; Charonne (boutique mixte); Charonne (boutique femmes); PES Charonne (75018); Charonne (Caarud) – Beaurepaire; Aides 75 (PES) – AUDVIH; Horizons (CSAPA); Hôpital Fernand Widal (CSAPA) - espace Murger.

Disclosure statement

The authors certify that they have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Additional information

Funding

This work was supported by the French National Agency for HIV and Hepatitis Research (ANRS). The ANRS is part of the French national institute of health and medical research (INSERM), which guarantees independent research. Its objective is to coordinate and fund all public research on AIDS and viral hepatitis B and C in France and countries particularly affected by these diseases. The ANRS enjoys a high level of autonomy in terms of scientific policy and budgetary management. ANRS had no further role in study design; the collection, analysis and interpretation of the data; in the writing of the report; and in the decision to submit the paper for publication.