Center for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark.
Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.
BMC Public Health. 2020 Jan 31;20(1):146. doi: 10.1186/s12889-020-8261-4.
Substance use disorders are a major risk factor for suicide. However, less is known about specific risk factors for suicide in people with substance use disorders.
This population cohort study assessed suicide among people treated for drug use disorders in Denmark 2000-2010, and described risk factors for completed suicide. Data from 27,942 individuals enrolled in treatment were linked to national registers and matched with controls without drug use disorder and with (n = 138,136) or without psychiatric history (n = 1574). Competing risk regression was used to identify risk factors of completed suicide.
There were 163 suicides among patients with a history of drug treatment (0.6% of patients). Increased risk was associated with younger age at enrolment (hazard ratio [HR] = 0.97, 95% confidence interval (CI): 0.95, 0.98), history of psychiatric care (HR = 1.96, CI 95%: 1.39, 2.77), opioid use (HR = 1.81, 95% CI: 1.23, 2.68), and alcohol use (HR = 1.56, 95% CI: 1.09, 2.23). Lower risk was associated with cannabis use (HR = 0.69, 95% CI: 0.50, 0.96). Compared with age- and gender-matched controls without a history of treatment for substance use disorders or recent psychiatric care, the standardized mortality ratio due to suicide was 7.13 for people with drug use disorder without a history of psychiatric care (95% CI: 5.81, 8.44), 13.48 for people with drug use disorder and psychiatric history (95% CI: 9.75, 17.22), and 13.61 for people with psychiatric history only (95% CI: 6.72, 20.50).
Risk of suicide is increased among people with drug use disorders. Access to treatment for co-morbid mental health problems for people with drug use disorders could potentially reduce risk of suicide.
物质使用障碍是自杀的一个主要危险因素。然而，对于物质使用障碍患者的自杀特定风险因素知之甚少。
本队列研究评估了 2000-2010 年在丹麦接受药物使用障碍治疗的人群中的自杀情况，并描述了自杀完成的风险因素。将 27942 名接受治疗的个体的数据与国家登记处相关联，并与无药物使用障碍的对照者（n=138136）或无精神病史的对照者（n=1574）相匹配。使用竞争风险回归来确定自杀完成的风险因素。
在有药物治疗史的患者中，有 163 人自杀（患者的 0.6%）。年龄较小（风险比 [HR] = 0.97，95%置信区间 [CI]：0.95，0.98）、有精神科治疗史（HR = 1.96，95%CI：1.39，2.77）、使用阿片类药物（HR = 1.81，95%CI：1.23，2.68）和酒精（HR = 1.56，95%CI：1.09，2.23）与风险增加相关。而大麻使用（HR = 0.69，95%CI：0.50，0.96）与风险降低相关。与无药物使用障碍治疗史或近期精神科治疗史且年龄和性别匹配的对照组相比，无精神科治疗史的药物使用障碍患者的自杀标准化死亡率为 7.13（95%CI：5.81，8.44），有精神科治疗史的药物使用障碍患者为 13.48（95%CI：9.75，17.22），仅有精神病史的患者为 13.61（95%CI：6.72，20.50）。
药物使用障碍患者的自杀风险增加。为药物使用障碍患者提供治疗合并精神健康问题的机会可能会降低自杀风险。
