Overdoses and Suicide Attempts: Different Relations to Psychopathology and Substance Abuse? A 5-Year Prospective Study of Drug Abusers

Abstract

Two hundred Norwegian drug abusers who consecutively applied for treatment in a therapeutic community were interviewed at intake and personally followed up on average 5 years after. Millon Clinical Multiaxial Inventory and Symptom Checklist-90 were used to assess the clients. Frequent use of opiates and number of months in inpatient treatment were associated with overdoses, while being a case on the Borderline scale or depression was related to suicide attempts. The study shows that overdoses and suicide attempts can be distinguished on the basis of their different psychopathological risk variables and their different relationship to substances. To understand the background of these phenomena is of importance in planning preventive action to hinder fatal overdose and suicide.

What Characterizes Substance Abusers Who Commit Suicide Attempts? Factors Related to Axis I Disorders and Patterns of Substance Use Disorders

“…Although many other studies also show that PS abusers are a high-risk group for attempted suicide, our PS abusers displayed a somewhat higher frequency [2,3,8,9,31] . Prevalence rates concerning suicide attempts in drug addicts, especially studies from Scandinavia, show a prevalence rate of 35-47% [4,8,9] . Frequencies of suicide attempts in our alcoholics are quite similar to data from other studies [2,7,32] .…”

“…The large variation in substance abusers may be due to differences in sampling, since most studies have been from single treatment institutions and thus the clinical representativeness is unclear. Although it is important to separate alcoholics from poly-substance (PS) abusers, some studies have examined only heroin addicts, others illicit drug users, while others have used mixed samples with different kinds of drugs and alcohol [4][5][6][7] . Since several studies indicate that PS abusers may have an especially high risk of attempting suicide [3,4,6,7] , different proportions of such abusers in the mixed clinical samples may have yielded different prevalence rates.…”

“…Although it is important to separate alcoholics from poly-substance (PS) abusers, some studies have examined only heroin addicts, others illicit drug users, while others have used mixed samples with different kinds of drugs and alcohol [4][5][6][7] . Since several studies indicate that PS abusers may have an especially high risk of attempting suicide [3,4,6,7] , different proportions of such abusers in the mixed clinical samples may have yielded different prevalence rates. A further problem is the participant gender, since women usually report a higher prevalence of attempted suicide than men [3][4][5]8] .…”

“…Since several studies indicate that PS abusers may have an especially high risk of attempting suicide [3,4,6,7] , different proportions of such abusers in the mixed clinical samples may have yielded different prevalence rates. A further problem is the participant gender, since women usually report a higher prevalence of attempted suicide than men [3][4][5]8] . In addition, most of the studies investigating gender differences have exclusively examined alcoholics or illicit drug users separately, and few compare female/male alcoholics with female/male PS abusers in the same sample.…”

“…The risk factors for suicide attempts in substance abusers are mostly the same as in the general population; being a woman, addiction severity, poly-drug use, disrupted family background, social disintegration, history of unsuccessful treatment and comorbid psychiatric disorders [3,4,6,[8][9][10][11][12][13][14][15][16][17][18] . Depressive disorders, antisocial and borderline personality disorders and attention defi cit-hyperactivity disorder are important risk factors for suicide attempts [5,[12][13][14][15][16][17] .…”