Toxicological Findings of Self-Poisoning Suicidal Deaths: A Systematic Review by Countries PMC

Reduced serotonin function has been identified in suicides and possibly in serious suicide attempters (see [139] for a review) and alcohol dependent patients [140]. Serotonin depletion was also found in individuals displaying aggressive and impulsive behavior [139] and was a predictor of both early-onset al.cohol use disorders [141] and suicide attempts among alcoholics [142,143]. Ethanol has been shown to potentiate acutely 5-HT3 receptor function and to modulate chronically 5-HT3-augmented mesolimbic dopaminergic function, but also to regulate alcohol drinking and its reinforcing properties at the ventral tegmental area level [145,146]. However, 5-HT3 receptors were not found to be altered postmortem in suicides [147].

A comparison of enzymatic and GC method for blood ethanol analysis

Results from time-series analyses on aggregate level data from several European countries indicates a stronger effect of alcohol consumption on suicide in low consumption countries than in high consumption countries [54–58]. (Washington, DC – July 31, 2024) – TFAH’s Pain in the Nation report series tracks levels of alcohol, drug, and suicide deaths nationally and for population groups. This 2024 edition, reporting on 2022 data, found that a decrease in the alcohol-induced mortality rate led to a slightly lower combined rate of all U.S. deaths due to substance misuse and suicide, but the long-term trend of such fatalities is still alarmingly high.

2. Analysis of Autopsies Related to Suicide by Poisoning

Alcohol use is highly prevalent worldwide, and suicide is highly prevalent in populations of patients with alcohol use disorders. However, co-morbid psychopathology is neither sufficient nor necessary for this association [14]. Alcohol use and suicide are intimately linked, but they are both complex phenomena, springing from a multitude of factors. Menninger dka breath smell conceptualized addiction itself both as a form of chronic suicide and as a factor involved in focal suicide (deliberate self-harming accidents) [25]. In 2016 alone, 11.8 million people misused opioids and 42,000 died by opioid-overdose [139]. Recent research suggests that a suicidal element may play a significant role in opioid overdose deaths [140, 141].

Experience with acute paraquat poisonings in Crete

To begin with, 494 duplicates were removed, and 914 records were screened. After full-text evaluation, another 208 records were excluded what foods have alcohol in them because they were unspecific. And G.D.A. If there was a conflict of opinions regarding the articles, they were submitted to A.A.

Disinhibition, in which alcohol acts to remove psychological and even physiological barriers to self-harm, has also been proposed as a relevant factor [193]. Altered glutamatergic receptors in the brains of people who died from suicide comprise reduced NMDA receptors [170] and increased caudate metabotropic receptors [171]. These findings are interesting in pointing to alcohol-suicide commonalities in neurochemical alterations but, unfortunately, these post-mortem findings in the brains of suicides are only partially matched by alterations found in brains of non-suicidal people with chronic alcoholism. Notably, GABAA receptors were reduced [172–174], but the subunit compositions only partly overlap with those found in suicides. In a study of 450 alcohol-dependent men conducted in the mid-eighties, suicide attempts predicted increased alcohol-related problems at one-year follow-up [69], but this has not been confirmed in later studies [70–72]. Recent findings from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) [32] indicate that the 12-month prevalence of DSM-IV-TR alcohol dependence in the adult population in USA is 3.8% and that of alcohol abuse 4.7% [33].

Indeed, rates of alcohol misuse have escalated over the last two decades [21, 22] in parallel with rising suicide rates [23, 24]. Since 2001, past-year prevalence of high-risk drinking has increased by 29.9%, and alcohol use disorder (AUD) by an alarming 49.4% [21]. Importantly, rising rates of alcohol misuse are accompanied by a 35% increase in alcohol-related suicide deaths [23]. The selected studies offer a snapshot of toxicological findings of autopsies in cases of suicide by self-poisoning worldwide. Significant differences between substances used in low-income and Western countries confirmed previous literature data. In rural areas and Asian countries, most suicides by poisoning occur mainly through the use of pesticides such as organophosphates and carbamates.

People with problematic alcohol use are also a vulnerable population and we owe them a special duty of care; that should also inform public policies. If it means saving a loved one, warning labels on beer cans seem like a pretty low price to pay. Celebrating at parties, cheering a favorite sports team, and enjoying get-togethers after work are common ways to relax or be with friends. For some people, these occasions may also include drinking—even binge or high-intensity drinking. If you think that someone has alcohol poisoning, get medical attention right away. Official statistics on suicides in 2016observed a decrease in the prevalence of self-poisoning for both males and females and a higher proportion of females using this suicide method (36.2% of females versus 18.3% of males).

Figure 1 indicates the impact of alcohol abuse and misuse on suicide risk and the importance of the detection and treatment of alcohol use disorders for suicide prevention. Therefore, suicide prevention should focus on the diagnosis and treatment of alcoholism [63] and other substance-related disorders. In view of the strong link between alcoholism and suicide, there is a clear need to provide public health education regarding sensible drinking.

Thus, these 3 causes of death should be considered separately when targeting public health interventions toward populations at the highest risk. Furthermore, it is important to reiterate that these increases are not limited to middle-aged White men and women, as they have impacted all racial/ethnic groups in recent years, nearly every US state, and rural and urban communities. In almost all industrialized countries, the highest suicide rate is found among men aged 75 years and older [207].

1. There are well-established links between alcohol and cancer, heart disease and violence.
2. An alcohol overdose occurs when there is so much alcohol in the bloodstream that areas of the brain controlling basic life-support functions—such as breathing, heart rate, and temperature control—begin to shut down.
3. One possible explanation for this finding is that women are more likely than men to poison themselves and alcohol may be used as one of the poisoning agents in combination with other substances.
4. It is possible that when one decides to commit suicide, he/she may select one of the options available to make the act more socially and personally acceptable, and one of these may be alcohol.
5. Velleman and Templeton [221] described the impact of parental substance use disorder on adolescents and young adults.

Our study indicates that, in the analyzed observation period, alcohol was frequently responsible for intentional (suicidal) (Table 5) and unintentional deaths as the cause of poisonings (Table 6). Antiepileptic, sedative-hypnotic, anti-parkinsons, and psychotropic drugs, not elsewhere classified, as well as other unspecified drugs, medicaments, and biological substances were the second cause of death as a result of intentional self-poisoning (Table 5). Poisoning by and exposure to other unspecified drugs, medicaments, over the counter xanax alternative and biological substances, as well as poisoning by and exposure to other gases and vapors, were the second cause of deaths as a result of undetermined intent (Table 6). The statistics for 2017–2020 revealed the emergence of new substances affecting the state of consciousness of suicide victims, and they showed the impact of new psychoactive substances, such as narcotic drugs and drugs (Table 3). It was observed that the number of suicide attempts committed under the influence of these substances has been increasing.

“Evaluation of the patient for co-existing medical and psychiatric diseases is an important part of the assessment of patients with AUDs, but too often ignored or complicated by detoxification,” said Rummans. For example, AUD patients with major depression have significantly more relapses. Table 3 also illustrates that there were statistically significant interactions of BAC and age, Asian/Pacific Islander race, and Hispanic ethnicity. The interaction suggested that among suicide decedents using alcohol, throughout the life course, BAC was generally highest among firearm suicides and lowest among poisoning suicides until late life (aged 75 years and older), when this pattern reversed.

The young age of the victims correlates with their vulnerability and impulsiveness and their easy access to toxic drugs [52,53]. Holmgren et al. [35] analyzed a case history of autopsies in suicides from 1998 to 2007 and found that 2462 (22%) of the suicides had been committed by consuming poison. Toxicological tests were conducted on urine, blood, and vitreous humor and found that the main substances used were paracetamol, antidepressants, and antipsychotics. Xiao et al. [22] studied 782 poison-related autopsy cases, 38.4% of which involved suicides by subjects with a mean age of 37 years, with a slight predominance of males over females. Toxicological investigations were conducted on blood, urine, and gastric content samples. They revealed the use of pesticides in 40% of the cases, toxic gases in 32% of the cases, drugs of abuse in 8.6% of the cases, and drugs and botanical derivatives in the rest.

Results also indicate that AUD is a potent risk factor for suicidal behavior. Risk estimates are higher for individuals with AUD in treatment settings, when compared to individuals in the community who have AUD. Also, although rates of suicide and prevalence of AUD remain higher in men, they have increased more among women in recent decades. Based on postmortem blood alcohol concentrations, AUA was commonly present among those who died by suicide.