Alcohol and other drugs in suicide in Canada: opportunities to support prevention through enhanced monitoring

Abstract

The use of alcohol and other drugs has been identified as a significant factor related to suicide through multiple pathways. This paper highlights current understanding of their contributions to suicide in Canada and identifies opportunities for enhancing monitoring and prevention initiatives. Publications from 1998 to 2018 about suicide in Canada and that referred to alcohol or other drugs were identified using PubMed and Google Scholar. A second literature search restricted to articles including results of toxicology testing was conducted by a librarian. We summarised the literature identified on ecological analyses, attributable fractions and deaths, and research including the results of toxicological analyses. Our literature search yielded 5230 publications, and 164 documents were identified for full-text screening. We summarised the findings from 30 articles. Ecological analyses support the association between alcohol sales, annual per capita alcohol consumption and suicide rates. Based on published estimates, approximately a quarter of suicide deaths in Canada are alcohol-attributable, while the estimated attributable fraction for illegal drugs is more variable. Finally, there is a dearth of literature examining the role of acute alcohol and/or drug consumption prior to suicide based on toxicological findings. The proportion of suicide decedents with drugs or alcohol present at the time of death varies widely. While there is evidence on the role of alcohol and drugs in suicide deaths, there is not a large body of research about the acute use of these substances at the time of death among suicide decedents in Canada. Our understanding of the role of alcohol and other drugs in suicide deaths could be enhanced through systematic documentation, which in turn could provide much needed guidance for clinical practice, prevention strategies and policy initiatives.

Suicide ideation in Canada during the COVID-19 pandemic

“…consumption has also been implicated in suicide, [19][20][21] and while the majority of Canadians surveyed report no changes in their alcohol use during the pandemic, a portion report increasing their consumption. 11,[22][23][24][25][26][27][28] With physical distancing guidelines limiting in-person social interactions to reduce the spread of COVID-19, loneliness has become relatively common, with 4 in 10 adults in Canada reporting feelings of loneliness or isolation due to the pandemic in Fall 2020.…”

Rural–Urban Differences in Suicide Mortality: An Observational Study in Newfoundland and Labrador, Canada: Différences de la Mortalité Par Suicide en Milieu Rural-Urbain: Une Étude Observationnelle à Terre-Neuve et Labrador, Canada

“…Alcohol is a known risk factor for suicide at both the population and individual level. 62 Among adolescents, alcohol consumption tends to be higher in rural areas, 63,64 and heavy drinking is more common among men and in rural communities. 65 Geographic patterns in alcohol use may have a role in the distribution of risk for suicide, especially in Newfoundland and Labrador where rates of heavy and risky drinking are elevated.…”

Prevalence of alcohol use among women of reproductive age in Canada

“…These include, but are not limited to, physical injury 2 , adverse physical and mental health effects 2,3 , can cer 4 , cirrhosis of the liver 5 and even death. 2,6,7 Canada's Low-Risk Alcohol Drinking Guidelines were published in 2011 to raise awareness to help reduce alcoholrelated harms. 8 These guidelines outline best practices for safe alcohol consumption, including recommendations to abstain from https://doi.org/10.24095/hpcdp.41.9.04 15 and 54 years old: weekly alcohol con sumption and heavy alcohol consumption.…”