Prevalence and Correlates of Suicidal Ideation Among Young Injection vs. Noninjection Drug Users

Abstract

The objective of this study was to identify correlates of suicidal ideation and to examine the hypothesis that injection drug users (IDUs) were more likely to report suicidal ideation than noninjection drug users (NIDUs). Participants included IDUs (n = 244) and NIDUs (n = 73) from Baltimore, Maryland, aged 15–30 who began snorting or smoking heroin or cocaine/crack (NIDUs) or injecting drugs (IDUs) within the past 5 years who were recruited between August 2000 and March 2002. Among the 317 participants, 42% were female, 59% were white, and median age was 24. The prevalence of suicidal ideation was 27%. IDUs were more likely to report suicidal ideation than NIDUs (31% vs. 14%, p = 0.003). Adjusting for age, gender, and race, IDUs were 2.4 times more likely than NIDUs to report suicidal ideation [95% Confidence Interval (CI): 1.1–5.2]. However, on further adjustment for homelessness, depressive symptoms, and gay/lesbian/bisexual identity, IDU status was no longer independently associated with suicidal ideation. These results suggest that factors associated with injection drug users' lifestyles and mental health status may account for the higher prevalence of suicidal ideation in IDUs vs. NIDUs. Further study into these associations is warranted in identifying avenues for suicide prevention among these populations.

Keywords:

• suicidal ideation
• drug use
• injection
• depression
• homeless
• sexual orientation
• risk behaviors

Additional information

Notes on contributors

Jennifer R. Havens

Jennifer Havens, Ph.D., MPH, is an Assistant Professor of Behavioral Science at the Center on Drug and Alcohol Research, University of Kentucky College of Medicine. She received her MPH and P.h.D. in Epidemiology at the Johns Hopkins Bloomberg School of Public Health. Dr. Havens' research interests include the epidemiology of prescription opioid abuse in Appalachia, risk behaviors among prescription and illicit opioid users, and the comorbidity of substance abuse and mental disorders.

Susan G. Sherman

Susan Sherman, Ph.D., MPH is an Assistant Professor in the Johns Hopkins Bloomberg School of Public Health. She is a behavioral scientist and epidemiologist with expertise in network oriented behavioral interventions with IDUs domestically and internationally. She has experience in studies of IDU dyads, social networks, overdose prevention, and ethnography in the United States, Thailand, and Pakistan.

Marcella Sapun

Marcella Sapun, MS, BS is a Research Data Manager II in the Data Coordinating Center for the HIV Research Network Project at the Johns Hopkins University School of Medicine. She received her Masters degree in Management Information Systems in the Business School at Bowie State University. Mrs. Sapun's research interests include the analysis of relevant data on the accessibility, quality, safety, use, and cost of health care services provided to persons with HIV disease.

Steffanie A. Strathdee

Steffanie Strathdee, Ph.D., is a Professor and Harold Simon Chair in International and Cross Cultural Medicine at the University of California, San Diego. She is also a faculty member in the departments of Epidemiology and International Health at the Johns Hopkins School of Public Health. Dr. Strathdee has extensive experience with the design and analysis of prospective epidemiologic studies, especially in HIV/AIDS. She has published more than 150 peer-reviewed publications on HIV prevention and the natural history of HIV infection. She also leads intervention studies to reduce HCV transmission and risk behaviors among HCV-seronegative and HCV-seropositive IDUs.