Community Medicine Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
Harm Reduct J. 2024 May 16;21(1):96. doi: 10.1186/s12954-024-01015-9.
Research regarding the contribution of specific psychoactive substances to suicidality has yielded equivocal results. The present study examined the prevalence and factors associated with suicidal thoughts and behaviors among a population-based sample of untreated illicit substance users.
A total of 616 illicit substance users who were recruited from high-risk areas of Shiraz using snowball sampling participated in the study. Eligible participants were individuals aged 18 years and older who regularly used one illicit psychoactive substance (e.g., opioids, heroin, cannabinoids, stimulants, hallucinogens) for at least one year and who had received no treatment for their drug use during the past year. Data were collected regarding socio-demographic characteristics, mental history, and substance use habits. Data regarding suicidal thoughts and behaviors were assessed using the Beck Suicidal Ideation Scale (BSIS) and self-reports of previous suicide attempts. Multiple logistic regression analysis was used to identify independent variables associated with suicidality.
Among the participants, 23.6% reported having had suicidal thoughts during the past week and 6.7% reported having attempted suicide during the past year. Methamphetamine was reported as the primary substance of use among approximately half of the participants who attempted suicide during past year (49.2%). Multiple logistic regression analysis showed that current suicidal thoughts were independently associated with having no job, a history of mental health condition, previous suicidal attempts, concurrent use of more than one substance, and using methamphetamine and heroin as the primary substances. Suicidal thoughts were not associated with increased odds of regular opium and cannabis use.
Both methamphetamine and heroin use are significantly associated with current suicidal thoughts. Evaluation of the risk of suicidality by physicians and mental health care professionals in both community and outpatient settings would be especially appropriate among those individuals using these psychoactive substances.
关于特定精神活性物质对自杀倾向的影响的研究结果喜忧参半。本研究调查了未经治疗的非法药物使用者人群样本中自杀意念和行为的流行情况及其相关因素。
本研究共纳入了 616 名通过滚雪球抽样法从设拉子高危地区招募的非法药物使用者。合格的参与者是年龄在 18 岁及以上的个体，他们至少一年来定期使用一种非法精神活性物质（例如阿片类药物、海洛因、大麻素、兴奋剂、致幻剂），并且在过去一年中未接受过药物治疗。收集了参与者的社会人口统计学特征、精神病史和物质使用习惯的数据。使用贝克自杀意念量表（BSIS）和自我报告的既往自杀企图评估自杀意念和行为的数据。使用多因素逻辑回归分析确定与自杀意念相关的独立变量。
在参与者中，23.6%报告在过去一周内有过自杀意念，6.7%报告在过去一年中有过自杀企图。在过去一年中有自杀企图的参与者中，约有一半报告主要使用的物质是甲基苯丙胺（49.2%）。多因素逻辑回归分析显示，目前的自杀意念与无工作、精神病史、既往自杀企图、同时使用一种以上物质以及主要使用甲基苯丙胺和海洛因独立相关。自杀意念与定期使用阿片类药物和大麻的几率增加无关。
甲基苯丙胺和海洛因的使用与目前的自杀意念显著相关。在社区和门诊环境中，医生和精神卫生保健专业人员评估这些精神活性物质使用者的自杀风险尤其合适。
