Kennedy Mary Clare, Marshall Brandon D L, Hayashi Kanna, Nguyen Paul, Wood Evan, Kerr Thomas
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, Canada V6Z 1Y6; School of Population and Public Health, University of British Columbia, 5804 Fairview Avenue, Vancouver, BC, Canada V6T 1Z3.
Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI 02912, USA.
Drug Alcohol Depend. 2015 Jun 1;151:272-7. doi: 10.1016/j.drugalcdep.2015.03.006. Epub 2015 Mar 19.
People who use illicit drugs (PWUD) are known to experience high rates of suicidal behavior. While heavy alcohol use has been associated with suicide risk, its impact on the suicidal behavior of PWUD has not been well characterized. Therefore, we examined the relationship between heavy alcohol use and suicidal behavior among PWUD in Vancouver, Canada.
Data are derived from two prospective cohort studies of PWUD in Vancouver, Canada, from 2005 to 2013. Participants completed questionnaires that elicited information regarding sociodemographics, drug use patterns, and mental health problems, including suicidal behavior. We used recurrent event survival analyses to estimate the independent association between at-risk/heavy drinking (based on National Institute of Alcohol Abuse and Alcoholism [NIAAA] criteria) and risk of incident, self-reported suicide attempts.
Of 1757 participants, 162 participants (9.2%) reported 227 suicide attempts over the 8-year study period, resulting in an incidence rate of 2.5 cases per 100 person-years. After adjusting for potential confounders, including intensive illicit drug use patterns, heavy alcohol use (adjusted hazard ratio [AHR] = 1.97; 95% confidence interval [CI] = 1.39, 2.78) was positively associated with an increased risk of suicidal behavior.
We observed a high burden of suicidal behavior among a community-recruited sample of PWUD. Heavy alcohol use predicted a higher risk of suicide attempt, independent of other drug use patterns. These findings demonstrate the need for evidence-based interventions to address suicide risk among PWUD, particularly those who are heavy consumers of alcohol.
已知使用非法药物的人（PWUD）有很高的自杀行为发生率。虽然大量饮酒与自杀风险有关，但其对PWUD自杀行为的影响尚未得到充分描述。因此，我们研究了加拿大温哥华PWUD中大量饮酒与自杀行为之间的关系。
数据来自2005年至2013年在加拿大温哥华对PWUD进行的两项前瞻性队列研究。参与者完成了问卷，这些问卷收集了有关社会人口统计学、药物使用模式和心理健康问题（包括自杀行为）的信息。我们使用复发事件生存分析来估计有风险/大量饮酒（基于美国国立酒精滥用与酒精中毒研究所[NIAAA]标准）与自我报告的首次自杀未遂风险之间的独立关联。
在1757名参与者中，162名参与者（9.2%）在8年的研究期间报告了227次自杀未遂，发生率为每100人年2.5例。在对包括密集非法药物使用模式在内的潜在混杂因素进行调整后，大量饮酒（调整后的风险比[AHR]=1.97；95%置信区间[CI]=1.39，2.78）与自杀行为风险增加呈正相关。
我们在一个社区招募的PWUD样本中观察到了很高的自杀行为负担。大量饮酒预示着更高的自杀未遂风险，与其他药物使用模式无关。这些发现表明需要基于证据的干预措施来解决PWUD中的自杀风险，特别是那些大量饮酒的人。
