Abstract

Objective

The rate of suicidal poisoning in the United States has increased substantially over the past 20 years. Understanding whether prescription medications used for self-poisoning were recently dispensed would help inform suicide prevention efforts. Alternatively, medications for self-poisoning could have been formerly dispensed or collected from friends, family, or illicit sources.

Methods

Among those who died by intentional opioid and psychotropic poisonings, we conducted a descriptive study to determine what proportion had a recently filled prescription that could have been the means of suicide. Subjects were all people who died by intentional poisoning across nine health-care systems within the NIH-funded Mental Health Research Network.

Results

Among the 3,300 people who died by suicide, 700 died by any poisoning and 194 died by intentional opioid or psychotropic/hypnotic medication poisoning. Among those who died by intentional opioid poisoning 73% were dispensed an opioid in the year prior. Among those who died by intentional psychotropic/hypnotic poisoning, 83% were dispensed any psychotropic and 61% were dispensed a hypnotic in prior year. Most people were continuously dispensed the same medications used in their intentional poisonings in the year prior to death.

Conclusions

Our results indicate that most medications used in suicidal overdose were likely recently dispensed. Therefore, future suicide prevention studies and prevention resources should focus on medication safety interventions such as lethal-means counseling for medication access, limiting quantities dispensed, opioid antagonists, and blister packs.

• HIGHLIGHTS

• Understanding whether medications used for self-poisoning were recently dispensed or formerly/never dispensed would help inform future studies and suicide prevention efforts.

• We found that most people who died by intentional poisoning with opioids or psychotropic/hypnotic medications received frequent dispensings of the medication used for self-poisoning in the year prior to death.

• Future suicide prevention studies and efforts should focus on medication safety interventions such as lethal-means counseling for medication access, limiting quantities dispensed, opioid antagonists, and blister packs.

中文翻译：

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因故意药物中毒而死亡的人在死亡前一年是否服用过这些药物？

摘要

客观的

过去20年来，美国的自杀中毒率大幅上升。了解最近是否发放了用于自毒的处方药将有助于为自杀预防工作提供信息。或者，用于自毒的药物可能是以前从朋友、家人或非法来源处分配或收集的。

方法

在那些因故意阿片类药物和精神药物中毒而死亡的人中，我们进行了一项描述性研究，以确定有多少比例的人最近服用的处方可能是自杀的手段。受试者是美国国立卫生研究院资助的心理健康研究网络内九个医疗保健系统中因故意投毒而死亡的人。

结果

在3300名自杀者中，700人死于任何中毒，194人死于故意阿片类药物或精神药物/安眠药中毒。在因故意阿片类药物中毒而死亡的人中，73% 在前一年服用了阿片类药物。在因故意精神药物/安眠药中毒而死亡的人中，83%的人在上一年服用过任何精神药物，61%的人在上一年服用过安眠药。大多数人在死亡前一年连续服用与故意中毒时使用的药物相同的药物。

结论

我们的结果表明，大多数用于自杀过量的药物可能是最近才配发的。因此，未来的自杀预防研究和预防资源应重点关注药物安全干预措施，例如药物获取的致命手段咨询、限制配药量、阿片类拮抗剂和泡罩包装。

• 强调

• 了解用于自毒的药物是最近配发的还是以前/从未配发的，将有助于为未来的研究和自杀预防工作提供信息。

• 我们发现，大多数因阿片类药物或精神药物/催眠药物故意中毒而死亡的人在死亡前一年经常收到用于自毒的药物。

• 未来的自杀预防研究和工作应侧重于药物安全干预措施，例如药物获取的致命手段咨询、限制配药量、阿片类拮抗剂和泡罩包装。