ED Visits for Drug-Related Suicide Attempts Double

Deborah Brauser

August 07, 2014

Two reports released today by the Substance Abuse and Mental Health Services Administration (SAMHSA) show a startling upturn in visits to hospital emergency departments (EDs) due to drug- related suicide attempts.

The first Drug Abuse Warning Network (DAWN) report from SAMHSA shows a 51% increase in these types of visits from 2005 to 2011 in individuals older than 11 years. In addition, there was a 58% increase during the same period for those between the ages of 18 and 29 years ― and a 104% increase for those between the ages of 45 and 64 years.

The second DAWN report, which looked specifically at this topic in the 45- to 64-year age range, showed that 96% of their 2011 visits involved over-the-counter medications and/or the nonmedical use of prescription drugs. Of these, 48% included antianxiety and insomnia medications, 29% included pain relievers, and 22% included antidepressants.

Alcohol and illicit drugs were also substantially used in these suicide attempts, at 39% and 11%, respectively.

"Suicide continues to take lives without regard to age, income, education, social standing, race, or gender," said SAMSHA administrator Pamela S. Hyde in a release.

"It is a growing risk in far too many segments of our society," she added.

Consistent Predictor

"Current data indicate that a past suicide attempt is the strongest consistent predictor for both repeat suicide attempts and suicide death," reports SAMHSA.

The organization notes that approximately 1 million adults attempted suicide between 2008 and 2009.

Both SAMHSA reports are based on combined results from the organization's 2005 to 2011 DAWN reports.

The first report shows that overall ED visits due to drug-related suicide attempts for individuals aged 12 years and older jumped from 151,477 in 2005 to 228,277 in 2011.

The biggest increases occurred for those between the ages of 18 and 29 years and those between 45 and 64 years. From 2005 to 2011, the number of visits for the first group rose from 47,512 to 75,068; for the latter group, the number rose from 28,802 to 58,775.

"In 2011, these two age groups comprised approximately 60% of all drug-related [ED] visits involving suicide attempts," SAMHSA wrote in their release.

The second DAWN report characterized ED visits involving drug-related suicide attempts in just the 45-year to 64-year age group in an attempt to better understand what is going on and to raise awareness of suicide risk factors.

"Historically, suicide prevention efforts primarily target teens, young adults, and the elderly, as these are the populations considered most at risk. However, suicide attempts (and the suicide death rate) among middle-aged adults has been increasing in recent years," writes SAMHSA.

The report shows that this age group accounted for 26% of all ED visits in 2011 due to drug-related suicide attempts, which is a significant increase from 19% in 2005.

In addition, visits doubled from 2005 to 2011 for both men (from 12,756 to 25,587) and women (from 15,942 to 33,188). Interestingly, 22% of all these type of visits in this age group did not result in follow-up care.

The number of visits involving over-the-counter medications or the nonmedical use of prescription drugs also doubled between 2005 and 2011, from 26,983 to 56,172. Visits resulting from the use of narcotic pain relievers in this way increased by 148%, and visits caused by the use of alcohol increased from 10,813 to 22,763.

Visits involving illicit drugs did not show significant increases.

"The suicide death rate has been steadily increasing in recent years," writes SAMHSA. "In the ED, a multidimensional assessment incorporating both risk and protective factors can assist with appropriate discharge planning (ie, follow-up care) and can help patients...and their families develop a safety plan."

They add that patient-specific suicide prevention interventions should continue even after discharge from follow-up care.

This type of careful monitoring, especially during the first 30 days after discharge, "can help reduce the risk of a repeat suicide attempt and potential suicide death," they write.

DAWN report 1 and report 2 can both be found on the SAMHSA Web site.

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