Associations of substance use patterns with attempted suicide among persons who inject drugs: Can distinct use patterns play a role?
Article [Accepted Manuscript]
Is part of
Drug and alcohol dependence ; vol. 147, pp. 208-214.Publisher(s)
ElsevierAuthor(s)
Affiliation
Keywords
Abstract(s)
Background: While the elevated risk of suicide attempt among persons who inject drugs
(PWID) is well documented, whether use of different substances is associated with varying
degrees of risk remains unclear. We sought to examine the associations between substance use
patterns and attempted suicide in a prospective cohort of PWID in Montreal, Canada.
Methods: Between 2004 and 2011, participants completed an interviewer-administered
questionnaire eliciting information on socio-demographic, substance use patterns, related
behaviors, and mental health markers. Generalized estimating equations were used to model the
relationship between self-reported use of six common substances (cocaine, amphetamine,
opioids, sedative-hypnotics, cannabis and alcohol), associated patterns of use (chronic,
occasional and none), and a recent (past six-month) suicide attempt.
Results: At baseline, of 1,240 participants (median age: 39.1, 83.7% male), 71 (5.7%) reported a
recent suicide attempt. Among 5,621 observations collected during follow-up, 221 attempts were
reported by 143 (11.5%) participants. In multivariate analyses adjusting for socio-demographic
and psychosocial stressors, among primary drugs of abuse, chronic [Adjusted Odds Ratio
(AOR): 1.97] and occasional (AOR: 1.92) cocaine use, and chronic amphetamine use (AOR:
1.96) were independently associated with attempted suicide. Among co-used substances, chronic
sedative-hypnotic use was independently associated with an attempt (AOR: 2.29). No
statistically significant association was found for the remaining substances.
Conclusion: Among PWID at high risk of attempted suicide, stimulant users appear to constitute
a particularly vulnerable sub-group. While the mechanisms underlying these associations remain
to be elucidated, findings suggest that stimulant-using PWID should constitute a prime focus of
suicide prevention efforts.
Other location(s)
Collections
This document disseminated on Papyrus is the exclusive property of the copyright holders and is protected by the Copyright Act (R.S.C. 1985, c. C-42). It may be used for fair dealing and non-commercial purposes, for private study or research, criticism and review as provided by law. For any other use, written authorization from the copyright holders is required.