British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada.
Drug Alcohol Depend. 2011 Dec 1;119(1-2):134-7. doi: 10.1016/j.drugalcdep.2011.05.012. Epub 2011 Jun 14.
Methamphetamine (MA) use is a growing public health concern in many settings around the world. While some physical and mental health effects associated with injection MA use have been well described, little is known about the relationship between injecting MA and suicidal behavior. We sought to determine whether MA injection was associated with an increased risk of attempting suicide among a prospective cohort of injection drug users (IDUs) in Vancouver, Canada.
Between 2001 and 2008, eligible participants enrolled in the Vancouver Injection Drug Users Study (VIDUS) completed semi-annual questionnaires that elicited information regarding sociodemographics, drug use patterns, and mental health problems including suicidal behavior. We used Cox proportional hazards models with time-dependent covariates to determine whether self-reported MA injection was an independent predictor of attempting suicide at subsequent time points.
Of 1873 eligible participants, 149 (8.0%) reported a suicide attempt, resulting in an incidence density of 2.5 per 100 person-years. Participants who attempted suicide were more likely to be younger (median: 35 vs. 40, p<0.01), female (48.3% vs. 35.1%, p<0.01), and of Aboriginal ancestry (43.6% vs. 31.3%, p<0.01). In a Cox proportional hazards model, MA injection was associated with an 80% increase in the risk of attempting suicide (adjusted hazard ratio=1.80, 95% CI: 1.08-2.99, p=0.02).
These findings suggest that IDUs who inject MA should be monitored for suicidal behavior. Improved integration of mental health and suicide prevention interventions within harm reduction and drug treatment programs may be fruitful.
在世界上许多地方，冰毒（MA）的使用是一个日益严重的公共卫生问题。虽然与注射 MA 使用相关的一些身心健康影响已经得到很好的描述，但对于注射 MA 与自杀行为之间的关系知之甚少。我们试图确定在加拿大温哥华的一个前瞻性注射吸毒者队列中，MA 注射是否与自杀企图风险增加有关。
在 2001 年至 2008 年期间，符合条件的参与者参加了温哥华注射吸毒者研究（VIDUS），完成了半年度问卷，其中包括社会人口统计学、药物使用模式以及包括自杀行为在内的心理健康问题。我们使用具有时间依赖性协变量的 Cox 比例风险模型来确定自我报告的 MA 注射是否是随后时间点自杀企图的独立预测因素。
在 1873 名符合条件的参与者中，有 149 名（8.0%）报告了自杀企图，导致发生率密度为每 100 人年 2.5 例。尝试自杀的参与者更年轻（中位数：35 岁与 40 岁，p<0.01）、女性（48.3%与 35.1%，p<0.01）和原住民血统（43.6%与 31.3%，p<0.01）。在 Cox 比例风险模型中，MA 注射与自杀企图风险增加 80%相关（调整后的危险比=1.80，95%CI：1.08-2.99，p=0.02）。
这些发现表明，应监测注射 MA 的 IDU 出现自杀行为。在减少伤害和药物治疗计划中更好地整合心理健康和自杀预防干预措施可能会有成效。
