Drug poisoning in the US
Information on drug poisoning suicide deaths in the US is not available at a very granular level. However, the following table1 does give a breakdown of 2006 suicide drug poisoning deaths:
|
Method |
No. |
% |
|
Other and unspecified drugs, medicaments and biological substances |
2,730 |
44.7% |
|
Other gases and vapours |
1,288 |
21.1% |
|
Anti-epileptic, sedative-hypnotic, anti-parkinsonism and psychotropic drugs, not elsewhere classified |
946 |
15.5% |
|
Narcotics and psychodysleptics [hallucinogens], not elsewhere classified |
678 |
11.1% |
|
Non-opioid analgesics, antipyretics and anti-rheumatics |
200 |
3.3% |
|
Organic solvents and halogenated hydrocarbons and their vapours |
120 |
2.0% |
|
Other and unspecified chemicals and noxious substances |
86 |
1.4% |
|
Alcohol |
27 |
0.4% |
|
Other drugs acting on the autonomic nervous system |
17 |
0.3% |
|
Pesticides |
17 |
0.3% |
|
Total |
6,109 |
|
According to the CDC2, 75% of intentional poisoning suicides were caused by drugs - both legal and illegal. The most commonly used drugs identified in drug-related suicides were psychoactive drugs, such as sedatives and antidepressants, followed by opiates and prescription pain medications1. Self-harm poisoning was the second-leading cause of emergency department visits for intentional injury in 20062.
In 2006, it was estimated by SAMHSA3 that attempted suicide led to 182,805 emergency department (ED) visits. Of those that made it to hospital, 31,528 were treated and released straight away, of the remainder, 101,409 were admitted (37,821 went into intensive care), with most the remaining 49,867 requiring transfer to another hospital for specialist treatment.
In these ED visits for attempted suicide, alcohol had been ingested in 30% of cases. In nearly two thirds of cases more than one drug was involved (with an average of 2.8 drugs for any person that took more than one drug).
The most popular drugs taken by those admitted were pain relief medications (most popularly opiates), benzodiazepines and other sedatives, anti-depressants (most popularly SSRIs), cocaine and antipsychotics (most popularly quetiapine which is used to treat post-traumatic stress disorder, anxiety, insomnia, autism and obsessive-compulsive disorder).
The American Association of Poison Control Centers (AAPCC)4 publishes data on phone calls they receive into their 61 centers which are designed to track the incidence of poison exposure (both intentional and unintentional) nationally. In 2007 they recorded 1,239 deaths by poisons (itself some way short of the figures provided by US Department of Health and Human Services for suicide alone), and the table below shows the drugs that appeared most frequently as the cause of death by poisoning.
Top 25 substance categories associated with deaths reported by 61 U.S. Poison Centers 2007
|
Substance |
No. |
% |
|
Sedative/hypnotics/antipsychotics |
377 |
30.4% |
|
Opioids |
331 |
26.7% |
|
Antidepressants |
220 |
17.8% |
|
Acetaminophen (paracetamol) in combination |
208 |
16.8% |
|
Cardiovascular drugs |
203 |
16.4% |
|
Stimulants and street drugs |
188 |
15.2% |
|
Alcohols |
170 |
13.7% |
|
Acetaminophen only |
140 |
11.3% |
|
Anticonvulsants |
99 |
8.0% |
|
Fumes/gases/vapors |
80 |
6.5% |
|
Cyclic antidepressants |
80 |
6.5% |
|
Muscle relaxants |
70 |
5.6% |
|
Antihistamines |
69 |
5.6% |
|
Aspirin alone |
63 |
5.1% |
|
Chemicals |
45 |
3.6% |
|
Unknown drug |
44 |
3.6% |
|
Other nonsteroidal anti-inflammatory drugs |
44 |
3.6% |
|
Oral hypoglycemics |
36 |
2.9% |
|
Automotive/aircraft/boat products |
28 |
2.3% |
|
Miscellaneous drugs |
21 |
1.7% |
|
Antihistamine/decongestant, without phenylpropanolamine |
21 |
1.7% |
|
Hormones and hormone antagonists |
20 |
1.6% |
|
Anticoagulants |
20 |
1.6% |
|
Diuretics |
16 |
1.3% |
It should be noted that the percentages exceed 100% as any one fatality may have had exposure to more than one substance. Indeed, consistent with data from SAMHSA, the breakdown of drugs shown for many of the fatalities reported by AAPCC showed more than one drug.
Sources
-
US Department of Health and Human Services, Centers for Disease Control and Prevention, WONDER online database (http://wonder.cdc.gov).
-
Centers for Disease Control and Prevention, National Center for Injury Prevention and Control (NCIPC), Poisoning in the United States: Fact Sheet http://www.cdc.gov/ncipc/factsheets/poisoning.htm.
-
Substance Abuse and Mental Health Services Administration (SAMHSA), Office of Applied Studies. Drug Abuse Warning Network (DAWN): National estimates of drug-related emergency department visits for 2004-2006 (https://dawninfo.samhsa.gov/files/ED2006/DAWN2k6ED.htm#High5).
-
Bronstein AC, Spyker DA, Cantilena LR, Green G, Rumack BH, Heard SE (2008), 2007 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 25th Annual Report, Clinical Toxicology.