MANNER OF DEATH Manner of death and circumstances in fatal poisonings: evidence from New Jersey

Objective: The objective of this study is to use a new data set to compare the circumstances of fatal poisoning in deaths ruled as suicides to those ruled as unintentional, particularly with regard to the prevalence of mental health, substance abuse, and other risk factors. Design: The design is an analysis of all fatal poisonings using data from the New Jersey Violent Death Reporting System. Patients or subjects: Decedents in New Jersey in 2003 whose cause of death was fatal poisoning, and whose manner of death was unintentional, intentional, or undetermined. Main outcome measures: The relation between risk factors, circumstances of death, and coded manner of death, particularly for those with both mental health and substance abuse related risk factors. Results: The prevalence of mental health risk factors was considerably higher among intentional poisonings (59.4% v 24.4%, p,0.0001), while that of substance abuse was higher among unintentional poisonings (90.0% v 24.5%, p,0.0001). Approximately 20% of unintentional poisonings and 25% of suicides had a physical health problem. Differences in circumstances by manner were smaller among those with a physical health problem. Conclusions: Substance abuse, mental health, and physical health problems were the most frequently cited risk factors for unintentional and intentional poisoning fatalities. There were many differences in characteristics and risk factors by manner of death. Those with physical health problems were more similar in terms of demographic characteristics and presence of other risk factors.