Association of alcohol and drug use disorders and completed suicide

An empirical review of cohort studies

Holly Wilcox, Kenneth R. Conner, Eric D. Caine

Research output: Contribution to journalArticle

Abstract

This study updated and expanded upon Harris and Barraclough's empirical review [Harris, E.C., Barraclough, B., 1997. Suicide as an outcome for mental disorders. A meta-analysis, Br. J. Psychiatry 170, 205-228] of retrospective and prospective cohort studies of alcohol and drug use disorders and suicide. Studies presenting data on alcohol and drug use disorders and suicide originally identified by Harris and Barraclough were used in this study. To find additional studies, (1) the location of English language reports on MEDLINE (1994-2002) were identified with the search terms 'substance-disorders' with 'mortality' and 'follow-up', (2) read throughs were conducted of four prominent alcohol and drug specialty journals from 1966 through 2002, and (3) the reference sections of studies that met criteria were searched for additional reports. This strategy yielded 42 new studies meeting eligibility criteria. The estimated standardized mortality ratios (SMR; 95% confidence interval) for suicide were as follows: alcohol use disorder (979; 95% CI 898-1065; p <0.001), opioid use disorder (1351; 95% CI 1047-1715; p <0.001), intravenous drug use (1373; 95% CI 1029-1796; p <0.001), mixed drug use (1685; 95% CI 1473-1920; p <0.001), heavy drinking (351; 95% CI 251-478; p <0.001). SMR estimates stratified by sex were also calculated. Additional studies on the association of suicide and mixed drug use, heavy drinking, and alcohol use disorders in women augmented the findings of Harris and Barraclough, along with a novel estimate for intravenous drug use, a byproduct of intensive research on HIV in the past decade. There is a large empirical literature on alcohol use disorders and suicide and a moderate literature on suicide and opioid use disorders and IV drug use. There remains limited prospective data on the association of suicide and other drug use disorders (e.g., cocaine, cannabis).

Original languageEnglish (US)
JournalDrug and Alcohol Dependence
Volume76
Issue numberSUPPL.
DOIs
StatePublished - Dec 7 2004

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Suicide
suicide
Substance-Related Disorders
drug use
Cohort Studies
alcohol
Alcohols
Pharmaceutical Preparations
Opioid Analgesics
Trimetrexate
mortality
Mortality
Cannabis
mental disorder
Cocaine
psychiatry
Mental Disorders
European Community
MEDLINE
Alcohol Drinking

Keywords

  • Epidemiology
  • Mortality
  • Substance-related disorders
  • Suicide

ASJC Scopus subject areas

  • Medicine(all)
  • Behavioral Neuroscience
  • Toxicology
  • Health(social science)

Cite this

Association of alcohol and drug use disorders and completed suicide : An empirical review of cohort studies. / Wilcox, Holly; Conner, Kenneth R.; Caine, Eric D.

In: Drug and Alcohol Dependence, Vol. 76, No. SUPPL., 07.12.2004.

Research output: Contribution to journalArticle

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