Department of Forensic Medicine, ESIC Medical College, Faridabad, 121001, India.
Department of Forensic Medicine, Amrita School of Medicine, Kochi, 682026, India.
Asian J Psychiatr. 2019 Aug;44:133-137. doi: 10.1016/j.ajp.2019.07.039. Epub 2019 Jul 25.
Prescription drug suicide merits study to guide the development of strategies to reduce suicide risk. We examined prescription drug suicide specifically in non-abusers of prescription drugs; this is a relatively unexplored subject.
Six-year data on prescription drug suicide in non-abusers were extracted from the records of the Department of Forensic Medicine at the All India Institute of Medical Sciences, New Delhi. These records contained information obtained from the scene of the suicide, from interviews with relatives of the deceased, and from forensic toxicological analyses at two laboratories.
There were 27 (8%) cases of prescription drug suicide in non-abusers out of 338 cases of suicidal poisoning. The mean age of this sample was 26 years. The sample was 74% male. Nearly half of the cases (44%) were students. A combination of dextropropoxyphene with dicyclomine, with or without paracetamol, was used by 41% of cases. Overdose was achieved through the ingestion of 10-40 (median, 30) tablets or by the injection of 2-3 (median, 2) vials of medication. In 52% of cases, it appeared that the drugs had been procured over the counter.
It is reassuring that the absolute number of prescription drug suicides in non-abusers was small; the findings, however, are important because they could serve as a baseline for assessing time trends in future studies. For the present, we suggest that prescription drugs of potential abuse, especially those containing opioids and antispasmodics, should be prescribed and dispensed judiciously, especially to youth.
处方药物自杀值得研究，以指导制定降低自杀风险的策略。我们专门研究了非处方药物滥用者的处方药物自杀问题；这是一个相对未被探索的课题。
从新德里全印度医学科学研究所法医系的记录中提取了六年的非处方药物滥用者的处方药物自杀数据。这些记录包含了从自杀现场、死者亲属访谈以及两个实验室的法医毒理学分析中获得的信息。
在 338 例自杀性中毒病例中，有 27 例（8%）为非处方药物滥用者的处方药物自杀。该样本的平均年龄为 26 岁。该样本中 74%为男性。近一半的病例（44%）为学生。41%的病例使用了右丙氧芬与双环维林的组合，有或没有对乙酰氨基酚。通过摄入 10-40 片（中位数，30 片）或注射 2-3 瓶（中位数，2 瓶）药物来实现过量。在 52%的病例中，这些药物似乎是在柜台购买的。
非处方药物滥用者的绝对自杀人数很少，这令人感到欣慰；然而，这些发现很重要，因为它们可以作为未来研究中评估时间趋势的基线。目前，我们建议谨慎开具和分发有潜在滥用风险的处方药物，尤其是含有阿片类药物和抗痉挛药物的药物，特别是对年轻人。
