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Toxicological Findings of Self-Poisoning Suicidal Deaths: A Systematic Review by Countries PMC

Further and continuous research is needed in this field to investigate and update the critical risk and protective factors involved in suicide and to implement prevention programs. Considering the limited resources and the large population in many low-income countries, it could be helpful to adopt public health measures by referring to social, religious, and economic factors to prevent suicide in various countries [52,53]. Medical drugs are also a common means of fatal poisoning, mostly in developed countries, with increased hospitalizations for poisoning by prescription opioids, sedatives, and tranquilizers.

How Prevalent Is Substance Misuse and Suicide in the United States?

Deaths were categorized as due to drug poisoning, suicide, or alcohol-induced causes based on underlying cause of death. Age-standardized incidence rates and annual percentage changes (APCs) in rates were estimated. Clusters of high-rate counties were identified with hot spot analysis. Excess deaths during 2001 to 2017 were estimated for each cause as the difference between the number of deaths observed and expected if rates had remained stable starting in 2000.

Materials and Methods

Data on the number of suicides per year are provided by the General Police Headquarters of Poland (the GPHP) and the Statistics Poland (GUS). The GPHP base their analysis on the KSIP-10 report on suicide attempt/behavior. It is not necessary to introduce the social security number of a victim there. Differences between the reporting systems lead to the discrepancies in the numbers of suicides, depending on the source of information. According to the literature and the results of the present study, pesticides are the most used toxic products in suicides by consuming poison in developing countries with agricultural bases. In this regard, one of the selected studies reported that in Iran, one reason for this high drug use is the free availability of drugs without prescription from legitimate pharmacy channels and through non-medical sources [26].

Statistical Analysis

To our knowledge this was the first study to examine the moderating effects of gender, age, and race/ethnicity on the presence of acute alcohol and the level of drinking across leading methods of suicide in a national sample. Results showed that among suicides tested for alcohol in the United States, alcohol was present in more than one third of the time in each of the leading methods of suicide. Moreover, among suicides that were tested and drank, alcohol levels were high, with the mean exceeding the legal limit of 0.08 grams per deciliter for drinking and driving. These results underscored the importance of considering both alcohol use and alcohol dosage in models of the drinking–suicide link.

  1. It has been observed that depressed subjects with a history of alcohol dependence had lower CSF HVA levels, compared with depressed subjects without a history of alcoholism [159].
  2. These findings simultaneously highlight the extraordinary concentration of disease burden, including suicide deaths, among people who have experienced incarceration, and the need for greater investment in improving the health of this population.
  3. According to this classification, suicide is a fourth order event in a set where the first order (i.e., the name of the set) is represented by Self-Injurious Thoughts and Behaviors.
  4. So, the poor antidepressant treatment response in subjects with co-morbid alcohol dependence and depression, or only with alcoholism, may have important negative effects also, such as increasing suicidality.
  5. Alcohol poisoning also can occur when adults or children accidentally or intentionally drink household products that contain alcohol.

Poisoning is a relevant public health issue responsible for a considerable number of cases of morbidity and mortality worldwide, especially in low- and middle-income countries [1]. According cocaine withdrawal to the World Health Organization (WHO), in 2000, unintentional poisoning led to around 350,000 deaths [2]. Meanwhile, around 250,000 deaths resulted from intentional ingestion [3].

All these elements indicate that suicide prevention in all countries should be rethought and reorganized. Furthermore, the role of the general practitioner should be strengthened in the care of suicidal patients because they are often on the front line. At the same time, psychiatrists are seldom directly solicited by these patients [56,58,59,60]. In the past 20 years, a decrease in deaths due to pesticide poisoning has been observed (from around 260,000 a year to 160,000 a year). However, more than 150,000 people still die from intentional ingestion of pesticides, accounting for about 20% of the global burden of suicide. The decrease in deaths is believed to be due to tighter regulation and increased mechanization of agriculture, resulting in reduced numbers of agricultural workers.

According to the results of meta-regression analysis, none of the covariates had a significant effect on the observed heterogeneity. The effects of covariates in the meta-regression are presented based on a logarithmic scale, so that ecstasy mdma or molly it is possible to estimate the risk of suicidal ideation, attempted suicide, and completed suicide based on different scenarios of moderator variables. We also searched the Psycinfo web site and journals and contacted authors.

When performing an autopsy in the case of suspected suicides, it is crucial to analyze social factors and medical history to pinpoint a suicide by self-poisoning and provide helpful information for prevention and public health measures. In this regard, the results of the present study lack significant information about sociodemographic factors. There is a high alcohol abuse disorder comorbidity rate in schizophrenia. McGirr et al. [252] choosing a drug rehab addiction program reported that, compared to other suicides, schizophrenic and schizoaffective suicides showed comparably elevated levels of impulsive aggressive traits. Evren and Evren [253] found that, among schizophrenic patients, young male patients who have antisocial personality properties and depressive symptoms should be considered at higher risk for suicide. The most common method of suicide in Poland is hanging, especially among men.

Official statistics on suicides in 2016observed a decrease in the prevalence of self-poisoning for both males and females and a higher proportion of females using this suicide method (36.2% of females versus 18.3% of males). Regarding other receptors involved in the action of ethanol, genetic polymorphisms have been found in suicidal persons for both the CRF1 [165] and CRF2 receptors [166], but the latter is not apparently involved in the action of ethanol [127]. However, mRNA for CRF1, but not CRF2 receptors, were found to be reduced in the frontal cortex of suicides, along with mRNA for the alpha1, alpha3, alpha4, and delta receptor subunits of the GABAA-benzodiazepine receptor cortex [167]. It has to be mentioned, however, that CRF receptor numbers and affinity have been reported to be either reduced [168] or unchanged by different groups of investigators [169].

First, wherever possible, we used the full adjusted forms of RR and OR controlling for factors such as age, gender, race, mental disorder, drug abuse, smoking, marital status, body mass index, educational level, employment status, income, and living alone. However, the confounding effect was not completely ruled out because some studies reported crude forms of RR or OR estimates. This issue may lead to overestimation of the overall measures of association.

Hot spot analysis identified statistically significant clusters of US counties with high (hot spots) and low (cold spots) drug poisoning, suicide, and alcohol-induced death rates (Figure 3). The largest significant cluster of counties with elevated drug poisoning death rates extended from the Northeast into Ohio, Indiana, Kentucky, Tennessee, West Virginia, and parts of Virginia and North Carolina. Additional significant hot spots were identified in New Mexico, Colorado, Utah, and Oklahoma. In contrast, the significant hot spots in suicide and alcohol-induced death rates were largely confined to the western half of the US, with hot spots for both causes of death from Montana and North Dakota to New Mexico and Arizona. Hot spots for of all 3 causes were present in New Mexico and Colorado. Research on methods of committing suicide and the risk factors involved in suicide by consuming poison is still inadequate.

When BAC reaches high levels, blackouts (gaps in memory), loss of consciousness (passing out), and death can occur. Alcohol in the form of ethanol, also called ethyl alcohol, is in alcoholic beverages. It’s also in mouthwash, some cooking extracts, some medicines and certain household products. Ethyl alcohol poisoning generally results from drinking too many alcoholic beverages in a short period of time.

The CDC’s National Center for Injury Prevention and Control [259] published guidelines for the development of intervention strategies for communities interested in adolescent and youth suicide prevention programs. The strategies focus on identifying youths at risk so as to direct them to healthcare centres, defining the risk factors, and providing support to manage stressful life events. The guidelines recommend making sure that suicide prevention programs are strongly linked with the mental health resources in the community.

Suicide is also both a social and a personal act and is related to conditions that render life difficult. It is possible that when one decides to commit suicide, he/she may select one of the options available to make the act more socially and personally acceptable, and one of these may be alcohol. In doing so, the person communicates to others and adapts to his/her environment. The results of research do not support the hypothesis that, when a youth gets drunk, this in itself leads to that youth deciding to commit suicide.

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