Suicide among people treated for drug use disorders: a Danish national record-linkage study

Abstract

Background: Substance use disorders are a major risk factor for suicide. However, less is known about specific risk factors for suicide in people with substance use disorders. Methods: This population cohort study assessed suicide among people treated for drug use disorders in Denmark 2000-2010, and described risk factors for completed suicide. Data from 27,942 individuals enrolled in treatment were linked to national registers and matched with controls without drug use disorder and with (n = 138,136) or without psychiatric history (n = 1574). Competing risk regression was used to identify risk factors of completed suicide. Results: There were 163 suicides among patients with a history of drug treatment (0.6% of patients). Increased risk was associated with younger age at enrolment (hazard ratio [HR] = 0.97, 95% confidence interval (CI): 0.95, 0.98), history of psychiatric care (HR = 1.96, CI 95%: 1.39, 2.77), opioid use (HR = 1.81, 95% CI: 1.23, 2.68), and alcohol use (HR = 1.56, 95% CI: 1.09, 2.23). Lower risk was associated with cannabis use (HR = 0.69, 95% CI: 0.50, 0.96). Compared with age-and gender-matched controls without a history of treatment for substance use disorders or recent psychiatric care, the standardized mortality ratio due to suicide was 7.13 for people with drug use disorder without a history of psychiatric care (95% CI: 5.81, 8.44), 13.48 for people with drug use disorder and psychiatric history (95% CI: 9.75, 17.22), and 13.61 for people with psychiatric history only (95% CI: 6.72, 20.50). Conclusions: Risk of suicide is increased among people with drug use disorders. Access to treatment for comorbid mental health problems for people with drug use disorders could potentially reduce risk of suicide.

Down and High: Reflections Regarding Depression and Cannabis

“…Two reviews (18, 57) and a populational study (64) failed to document significant changes in suicidal ideation or behavior in people with MDD after adjusting for confounding factors. Finally, a study by Hesse et al found that compared to the general population, suicide was actually less frequent in individuals with CUD who received treatments in centers for substance use disorders (HR = 0.69) (92). In all, the preponderance of evidence suggests that cannabis use is not associated with suicidal ideation, suicide attempts or completed suicide in MDD.…”

Longitudinal Patterns of Suicidality Among Heroin Users in Johannesburg, South Africa: A Need for Suicide Screening and Intervention

“…As is the trend with gender and suicide in the general population, men who use heroin have higher rates of completed suicide than women, however women who use heroin have higher rates of suicide attempts ( 1 ). With regard to psychopathological symptoms, a diagnosis of major depression, depressive symptoms, anxiety symptoms, post-traumatic stress disorder and antisocial personality disorder have been reported to increase the risk for suicide attempts, and in some instances completed suicide in heroin users ( 6 – 8 , 16 – 19 ). Reports on suicide decedents in the general population show that one-third of people who died by suicide had a general medical illness at the time of death ( 20 ) and people with HIV have approximately a seven times higher risk for suicide than the general population ( 21 ).…”

New Psychoactive Substances and Suicidality: A Systematic Review of the Current Literature

“…In addition, substance use was found to be an independent risk factor for suicide attempt [14]. Substance use disorder (SUD) is considered an important risk factor for suicide, with vulnerable categories identified as younger age, history of psychiatric care, and opioid and alcohol use [15][16][17]. Indeed, substance use, substance intoxication, and pathological substance use have been demonstrated to be positively associated with suicidal behavior [18].…”