Self-poisoning across ages in men and women – Risk for suicide and accidental overdoses

Self-poisoning with licit or illicit opioids, alcohol or other prescribed drugs affects mostly young people, but also older patients are at risk for self-poisoning and suicide. This study investigates suicide methods and drugs involved in 2342 Swedish patients and compares different age categories regarding drug use and causes of death included suicide. All consecutive patients who had been treated for self-poisoning at the emergency department at the Karolinska University Hospital, from 1994 to 2000 were followed up until year 2006 for mortality. Of the whole cohort of 2342 (943 men and 1299 women) at an average age of 38.74 years at admission, 122 (5.2%) had committed suicide during the follow-up period. Standard mortality ratio (SMR) was highest (SMR=70.89) in patients older than 55 years, followed by the youngest age category (15-35 years) (SMR=61.95). Poisoning as suicide method was most common in the younger age categories, while violent methods in older ages. The drugs involved in the suicide cases were predominantly prescribed or illicit opioids in the youngest ages, while alcohol and medications were most common in the elderly. Patients presented to emergency department due to self-poisoning are at high risk for subsequent suicide in comparison with the general population. Women had significantly lower suicide rate, but no differences between men and women were found concerning type of suicide methods. Patients at emergency department due to poisoning should be offered treatment and follow-up for both drug abuse but also for psychiatric problems in order to prevent repetitive overdoses, suicides and other deaths.