Medicine self‐poisoning and the sources of the drugs in Lund, Sweden

Abstract

The purpose of this study was to investigate the prevalence of toxic agents in attempted and completed suicides. The purpose was also to explore the sources of the drugs taken by suicide attempters. Verbal information on drug intake was collected from 280 suicide attempters during 1987-1990 in the Lund-Orup catchment area. Information on the sources of the drugs was collected from 143 of these attempters. The study also includes toxicological screening from 73 fatal poisonings in southern Sweden during 1989. According to verbal information, the most common drugs used by suicide attempters were benzodiazepines (51%), analgesics (29%) and antidepressants (20%). In suicide attempters, diazepam and levomepromazine were reported more than expected from prescription data. Toxicological screenings of fatal poisonings showed that benzodiazepines were most common (55%), followed by analgesics (38%), mainly propoxyphene (29%) and antidepressants (30%), mainly amitriptyline (22%). Amitriptyline and diazepam were more commonly detected in completed suicides than expected from prescription data. The most common sources of drugs to attempted suicides were physicians, and especially psychiatrists. We therefore conclude that continuous information to physicians on drug overdose is important, and it is also important to introduce alternative strategies to prevent suicidal behaviour.

Method of Suicide in Relation to Some Sociodemographic Variables in Northern Sweden

“…This may be due to a steady increase in the availability of motor vehicles and drugs during the transformation of this region from a largely agricultural society into a modern industrialized society. Also in other industrialized countries, an increasing availability of motor vehicles and drugs has been accompanied by a rise in the frequency of suicide by petrol gases (Cantor & Baume, 1998), and by drug poisoning (Alsen et al, 1994;Bille-Brahe & Jessen, 1994;Hawton et al, 1997).…”

The effects of diazepam on human self-aggressive behavior

“…Given that this is the first study to experimentally examine the effects of a benzodiazepine on human self-aggressive behavior, it was important that a prototypical benzodiazepine be used, as well as one that has been associated with suicidal behavior in extra-laboratory settings. Indeed, diazepam is among the most frequently prescribed benzodiazepines and is overrepresented in both attempted (Alsén et al 1994;Fuller et al 1989) and completed (Fuller et al 1989) suicides. Moreover, diazepam reliably elicits impulsive other-directed aggressive behavior in laboratory studies of humans (Ben Porath and Taylor 2002; Gantner and Taylor 1988;Gardos et al 1968;Weisman et al 1998;Wilkinson 1985) and may therefore be associated with impulsive self-directed aggressive acts.…”

Forensic Toxicology in Urban South Africa

“…When these figures are compared with those from US, 17,18 Europe, [19][20][21][22] Australia, and Hong Kong, where pharmaceuticals are by far the predominant cause of death by poisoning, 23-27 a number of differences are noted. There is a major disproportion in the number of cases related to agricultural chemicals.…”