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Those who died by self\u2010injury reasoned to be deliberate were included in the analysis. Femoral blood alcohol concentration (BAC) and presence of cocaine or benzoylecognine (a metabolite of cocaine) in blood and\/or urine were tabulated and odds ratios calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1722 decedents met inclusion criteria. BAC was \u226550\u2009mg\/dL in 29% of decedents. Cocaine was detected in 8.4% of cases. The likelihood of testing positive for cocaine increased with BAC and was most frequent between 100 and 199\u2009mg\/dL, consistent with moderate to severe intoxication (odds ratio 5.88, 95% confidence interval 3.80, 9.09; <jats:italic>P<\/jats:italic>\u2009\u2264\u20090.001) compared to those with BAC &lt;10\u00a0mg\/dL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and Conclusions<\/jats:title><jats:p>This study demonstrates a correlation between increasing BAC and likelihood of cocaine use prior to suspected suicide, up to a level consistent with severe intoxication. Cocaine use was found in a high proportion of cases relative to the general population reporting regular use. This pattern of drug and alcohol use has previously been given little attention in suicide prevention strategies and clinical prioritisation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dar.13260","type":"journal-article","created":{"date-parts":[[2021,3,14]],"date-time":"2021-03-14T19:01:10Z","timestamp":1615748470000},"page":"1195-1201","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Alcohol and cocaine use prior to suspected suicide: Insights from toxicology"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9070-8058","authenticated-orcid":false,"given":"James","family":"Bailey","sequence":"first","affiliation":[{"name":"Department of Primary Care King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola J.","family":"Kalk","sequence":"additional","affiliation":[{"name":"Addictions Psychiatry Clinical Academic Group South London and Maudsley NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Andrews","sequence":"additional","affiliation":[{"name":"Toxicology Unit Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Yates","sequence":"additional","affiliation":[{"name":"Addictions Psychiatry Clinical Academic Group South London and Maudsley NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Limon","family":"Nahar","sequence":"additional","affiliation":[{"name":"Toxicology Unit Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Kelleher","sequence":"additional","affiliation":[{"name":"Addictions Psychiatry Clinical Academic Group South London and Maudsley NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Paterson","sequence":"additional","affiliation":[{"name":"Toxicology Unit Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,14]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Health profile for England: 2017. 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