Characteristics of Suicides and Toxicology in a Cohort of Individuals With Opioid Use Disorder

Abstract

Suicide in patients with opioid use disorder (OUD) is a complex issue. In addition to accidental intoxications, a higher prevalence of fatal suicides in patients with OUD can be found compared to the general population. In this study, suicides with a diagnosis of OUD documented in the project “Suicides, A National Survey” were extracted from our data bank. Individuals with a diagnosis of OUD in their medical history were compared to other suicides. The analyses included clinical and demographic factors as well as an investigation of suicide methods and toxicology of psychotropic drugs. For the statistical analyses, we applied chi-square tests and calculated odds ratios. Out of 6,495 suicide cases in Switzerland between 2000 and 2010, 215 individuals with a medical history of OUD could be identified. Persons in OUD cases were significantly younger than in other suicide cases (p < .001) and had more frequently a positive history for suicide attempts (p = .02). In addition, persons in OUD cases were more often female (p = .076). Intentional self-poisoning with medication was applied more often in individuals with OUD compared to other suicide methods (p < .001). When self-poisoning with drugs was compared to violent suicide methods, a combination of benzodiazepines with antidepressants was predominantly found. Our study yielded significant characteristics and risk factors for suicides in individuals with OUD. The predominant method of suicide in individuals with OUD was intended self-poisoning by medication. This knowledge is of clinical importance for the monitoring of at-risk individuals with OUD as well as for suicide prevention in this patient group.

Keywords:

• Methods of suicide
• opioid use disorder
• self-poisoning

DISCLOSURE STATEMENT

No potential conflict of interest was reported by the author(s).

AUTHOR CONTRIBUTION

Dr. P. Pfeifer contributed to the data analysis. Prof. Dr. C. Bartsch and Prof. Dr. T. Reisch contributed to the project coordination. Dr. P. Pfeifer, N. Nigg-Trawally, Prof. Dr. C. Bartsch, and Prof. Dr. T. Reisch participated in the writing of the manuscript. All authors approved the final manuscript prior to submission. N. Nigg-Trawally contributed to the data collection.

Additional information

Funding

Swiss National Science Foundation – Suicide in Switzerland: A Detailed National Survey of the Years 2000–2010. Number: 133070.

Notes on contributors

Philippe Pfeifer

Dr. Philippe Pfeifer, Specialist in Psychiatry and Psychotherapy, Consultant and research associate in the University Psychiatric Department of the University of Bern, Bern, Switzerland.

Natalie Nigg-Trawally

Natalie Nigg-Trawally, Doctorate Student.

Christine Bartsch

Prof. Dr. Christine Bartsch, Specialist in legal and forensic medicine, Berlin School of Economics and Law, Berlin, Germany.

Thomas Reisch

Prof. Dr. Thomas Reisch, Specialist in Psychiatry and Psychotherapy, Director of the Psychiatriezentrum Münsingen. Head of the research group suicidality at the University Psychiatric Department of the University of Bern, Bern, Switzerland.