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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=1,574). 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 co-morbid mental health problems for people with drug use disorders could potentially reduce risk of suicide.
Keywords
drug use disorder, suicidal behaviour, mental health, treatment, longitudinal study, cohort, competing risks
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CURRENT STATUS: Published
View the published article at BMC Public Health.
Version 3
Posted 24 Jan, 2020
No community comments so far
Submission checks complete
On 23 Jan, 2020
Editorial decision: Accept
On 22 Jan, 2020
No comments provided
Editorial decision: Minor revision
On 14 Jan, 2020
Review #2 received
Received 06 Jan, 2020
Reviewer #2 agreed
On 12 Dec, 2019
Reviewers invited
Invitations sent on 09 Dec, 2019
Reviewer #1 agreed
On 09 Dec, 2019
Review #1 received
Received 09 Dec, 2019
Editor assigned
On 04 Dec, 2019
Submission checks complete
On 03 Dec, 2019
Editor invited
On 03 Dec, 2019
No comments provided
Editorial decision: Major revision
On 24 Oct, 2019
Review #2 received
Received 21 Oct, 2019
Reviewer #2 agreed
On 05 Oct, 2019
Review #1 received
Received 17 Sep, 2019
Reviewer #1 agreed
On 02 Sep, 2019
Reviewers invited
Invitations sent on 01 Sep, 2019
Editor assigned
On 28 Aug, 2019
Submission checks complete
On 27 Aug, 2019
Editor invited
On 27 Aug, 2019
First submitted
On 05 Aug, 2019
Metrics
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PDF Downloads: ...
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Subject Areas
Health Policy
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A new preprint design is coming!
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See the published version of this preprint at BMC Public Health.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Public Health.
Version 3
Posted 24 Jan, 2020
No community comments so far
Submission checks complete
On 23 Jan, 2020
Editorial decision: Accept
On 22 Jan, 2020
No comments provided
Editorial decision: Minor revision
On 14 Jan, 2020
Review #2 received
Received 06 Jan, 2020
Reviewer #2 agreed
On 12 Dec, 2019
Reviewers invited
Invitations sent on 09 Dec, 2019
Reviewer #1 agreed
On 09 Dec, 2019
Review #1 received
Received 09 Dec, 2019
Editor assigned
On 04 Dec, 2019
Submission checks complete
On 03 Dec, 2019
Editor invited
On 03 Dec, 2019
No comments provided
Editorial decision: Major revision
On 24 Oct, 2019
Review #2 received
Received 21 Oct, 2019
Reviewer #2 agreed
On 05 Oct, 2019
Review #1 received
Received 17 Sep, 2019
Reviewer #1 agreed
On 02 Sep, 2019
Reviewers invited
Invitations sent on 01 Sep, 2019
Editor assigned
On 28 Aug, 2019
Submission checks complete
On 27 Aug, 2019
Editor invited
On 27 Aug, 2019
First submitted
On 05 Aug, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Health Policy
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Public Health.
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=1,574). 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 co-morbid mental health problems for people with drug use disorders could potentially reduce risk of suicide.
Figure 1
Figure 2
Figure 3
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