{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T03:39:28Z","timestamp":1792726768228,"version":"4.5.0"},"reference-count":40,"publisher":"American Medical Association (AMA)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Psychiatry"],"published-print":{"date-parts":[[2023,11,1]]},"abstract":"<jats:sec id=\"ab-yoi230051-4\"><jats:title>Importance<\/jats:title><jats:p>Determining the association between drug use and suicide is complicated but can help to inform targeted suicide prevention strategies.<\/jats:p><\/jats:sec><jats:sec id=\"ab-yoi230051-5\"><jats:title>Objective<\/jats:title><jats:p>To examine the substances prevalent in poisoning- and nonpoisoning-related suicides in Australia.<\/jats:p><\/jats:sec><jats:sec id=\"ab-yoi230051-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This was a multiple-year, cross-sectional study of suicides from July 2013 to October 2019 in Australia with toxicology data available in a national coronial database. The cause of death was classified as poisoning related if any type of poisoning was determined by the coroner to contribute to the cause of death. Prevalence ratios (PRs) were calculated to compare substance detection in poisoning- vs nonpoisoning-related suicides. Data were analyzed from October 2021 to April 2023.<\/jats:p><\/jats:sec><jats:sec id=\"ab-yoi230051-7\"><jats:title>Exposures<\/jats:title><jats:p>All substances detected in decedents at the time of death according to toxicology reports were recorded.<\/jats:p><\/jats:sec><jats:sec id=\"ab-yoi230051-8\"><jats:title>Main Outcome(s) and Measure(s)<\/jats:title><jats:p>The most common individual substances and substance classes were identified. From these, blood concentrations of substances of interest were analyzed, and the most commonly occurring combinations of substance classes were listed.<\/jats:p><\/jats:sec><jats:sec id=\"ab-yoi230051-9\"><jats:title>Results<\/jats:title><jats:p>Toxicology was performed on 13\u202f664 suicide decedents (median [IQR] age, 44 [31-57] years; 10\u202f350 male [76%]). From these, 3397 (25%) were poisoning-related suicides (median [IQR] age, 50 [38-63] years; 2124 male [63%]). The remainder were classified as nonpoisoning-related suicides (median [IQR] age, 42 [29-55] years; 8226 male [80%]). PRs for common medicine classes being detected in poisoning-related suicides compared with nonpoisoning-related suicides were as follows: antidepressants (PR, 1.63; 95% CI, 1.54-1.73), benzodiazepines (PR, 2.01; 95% CI, 1.90-2.13), nonopioid analgesics\/anti-inflammatory drugs (PR, 1.88; 95% CI, 1.78-2.00), and opioids (PR, 2.72; 95% CI, 2.58-2.87). Alcohol (as ethanol \u22650.03 g\/100 mL) was almost equally prevalent in poisoning- and nonpoisoning-related deaths (PR, 1.07; 95% CI, 1.01-1.14), whereas amphetamines (PR, 0.68; 95% CI, 0.61-0.77) and cannabinoids (PR, 0.67; 95% CI, 0.60-0.74) were detected more often in nonpoisoning-related suicides. Combinations of multiple sedative agents in poisoning-related suicides were common.<\/jats:p><\/jats:sec><jats:sec id=\"ab-yoi230051-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>Both poisoning- and nonpoisoning-related suicide deaths featured a high prevalence of psychotropic medicines or potential intoxication, which suggests the association of suicide with poor mental health and substance misuse. Findings suggest that substances with a high involvement in poisoning-related suicides should be prescribed cautiously, including antidepressants that are toxic in overdose, sedatives, opioids, and potentially lethal combinations.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamapsychiatry.2023.2289","type":"journal-article","created":{"date-parts":[[2023,7,26]],"date-time":"2023-07-26T13:58:30Z","timestamp":1690379910000},"page":"1121","source":"Crossref","is-referenced-by-count":16,"title":["Substances Detected During Coroner Postmortem Toxicology Analyses in Poisoning- and Nonpoisoning-Related Suicides"],"prefix":"10.1001","volume":"80","author":[{"given":"Jessy S.","family":"Lim","sequence":"first","affiliation":[{"name":"Biomedical Informatics and Digital Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia"},{"name":"School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, 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Southbank, Melbourne, Victoria, Australia"},{"name":"Department of Forensic Medicine, Monash University, Melbourne, Victoria, Australia"},{"name":"Monash Addiction Research Centre, Monash University, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea L.","family":"Schaffer","sequence":"additional","affiliation":[{"name":"School of Population Health, University of New South Wales, Sydney, New South Wales, Australia"},{"name":"Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate M.","family":"Chitty","sequence":"additional","affiliation":[{"name":"Biomedical Informatics and Digital Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia"},{"name":"School of Population and Global Health, The University of Western Australia, Perth, 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