Over‐the‐counter drug use in suicidal/self‐harm behavior: Scoping review

Abstract

Background and aims: Minor physical ailments are treated with over-the-counter (OTC) medications. The availability of OTC drugs helps reduce waiting times and ease the suffering of many. Suicidal behavior includes suicidal ideation, attempts, and completed suicides and affects people of all ages, religions, and cultures. This study aims to review use of OTC drugs for self-harm and suicidal attempts.Methods: We reviewed English language publications from the beginning of time to October 2021 on OTC drug use for suicidal behavior.Results: Twenty-seven studies met the eligibility criteria, and 1,816,228 participants were reported in these publications. OTC analgesics and sedatives/hypnotics were frequently used for suicidal behavior. Females and young people mainly were reported to self-harm using OTC medications. An increase in OTC analgesic use for self-harm in adolescents during the school months was reported. Elderly persons use hypnotics more frequently for suicidal attempts. Persons with major psychiatric disorders were reported to use OTC for suicidal behavior. Conclusion:The available information shows that the prevention strategies should focus on OTC analgesics and hypnotic use among women, the young, the elderly, and persons with mental health disorders.

Clinical characteristics and outcomes of patients with mental illnesses who attempted suicide by drug overdose: A retrospective analysis of 109 cases

“…We also found that the majority of suicide attempts by drug overdose were young people (18–43 years old), which was consistent with previous studies (Yasuda & Kobayashi, 2019 ). A previous scoping review found that over‐the‐counter analgesics and hypnotics were frequently used by the females, the young, and people with mental disorders for self‐harm and suicidal behaviors (Shoib et al., 2022 ). A possible explanation is that young patients are more likely to suffer from depressive episodes and need to cope with higher life stress.…”

Identification of Factors Necessary for Gatekeeper of Overdose

“…2) OTC drug overdose has been increasing in recent years. [3][4][5][6] In addition, the stress of the coronavirus disease-2019 (COVID-19) pandemic had increased overdose mortality in the United States and Canada. 7) Furthermore, drug overdose is a method of committing suicide.…”

Case Report of Lethal Concentrations of the Over-the-Counter Sleep Aids Diphenhydramine and Melatonin

“…In pregnant women, OTC nonopioid analgesics are used in roughly half of all intentional poisoning suicide attempts. This is further complicated by the role of health care professionals in providing care because they are generally unaware of nonprescribed medications and do not keep a record of their use 4,5 …”

“…This is further complicated by the role of health care professionals in providing care because they are generally unaware of nonprescribed medications and do not keep a record of their use. 4,5 The purpose of this report is to shed light on the potential misuse and toxicity of both DPH and melatonin, to encourage further investigation of the lethality of OTC medications, and to emphasize the importance of the role of death scene investigation and communication with laboratory consultants in "negative" autopsy cases. In addition, we hope this report will aid in increasing the general public's awareness of these potentially dangerous substances.…”

“…This is further complicated by the role of health care professionals in providing care because they are generally unaware of nonprescribed medications and do not keep a record of their use. 4 , 5 …”