Date of Award

Spring 5-4-2021

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Dr. Owen-Smith

Second Advisor

Rachel Geller, M.D

Abstract

Background: Substance use and abuse is strongly associated with higher rates of suicidal ideation, attempts, and ultimately suicide completion. The study objective was to examine the presence of alcohol and psychoactive drugs in the blood of individuals who died by suicide. Research aims were (1) explore the prevalence of alcohol and toxicological drugs in individuals who died by suicide by various demographic characteristics, (2) explore the prevalence of alcohol and specific toxicological drugs by methods of suicide, and (3) determine whether pharmaceutical and illicit drugs were associated with the method of suicide (specifically violent-non-drug-related means vs. drug-related means).

Methods: Data was extracted from the Medicolegal Death Investigation log database, retrieved from 2017-2020 within the metro-Atlanta region. Descriptive analyses and regression analyses were conducted.

Results:The presence of alcohol and psychoactive drugs in the blood of individuals who died by suicide had the highest percentages among the age group 25-44, White males that resided in middle-income areas. There were notable differences between detected drugs and methods of suicide. The top five identified drugs were Amphetamines (N=83), Cocaine (N=32), Anti-Depressants (N=27), Opioids (N=24), and Benzodiazepines (N=20). These identified drugs were more common in decedents who used firearms, hanging/ asphyxia, and poisoning/ drug overdose. Individuals who tested positive for pharmaceutical drugs had lower odds of violent-non-drug-related death compared to drug-related death (OR=0.006; 95% CI=0.001-0.027, p

Conclusion: Results of this study were consistent with previous research on the prevalence of alcohol among individuals who died by suicide across various demographic characteristics, however, the prevalence of drugs contradicted findings from other studies. Findings that individuals who tested positive for illicit drugs had higher odds of violent-non-drug-related death compared to drug-related death means support the importance of reducing access to lethal means of self-harm (particularly firearms) for a person at risk of suicide is an important part of a comprehensive approach to suicide prevention.

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