Suicides by drug overdose rising among some groups

While suicides by drug overdose appear to be declining, a recent study found increases in certain groups, including teens and younger adults, Black women, and older adults.

Women are also more likely than men to end their lives with an intentional drug overdose, according to the study led by investigators at the National Institute of Drug Abuse, part of the National Institutes of Health.

Nora Volkow, director of the drug abuse institute, was the senior author on the study, which was published Feb. 2 in the American Journal of Psychology.

“The distinction between accidental and intentional overdose has important clinical implications, as we must implement strategies for preventing both,” Volkow said in a news release accompanying the study.

“To do so requires that we screen for suicidality among individuals who use opioids or other drugs, and that we provide treatment and support for those who need it, both for mental illnesses and for substance use disorders.”

About 92,000 people died of drug overdoses in 2020, and that’s nearly five times higher than the number of fatal overdoses in 1999.

The NIDA notes it’s difficult to tell if some overdoses are intentional. It’s estimated that 5% to 7% of drug overdose deaths are intentional, but the institute says it’s likely a higher number.

Findings among groups

The study found intentional overdose deaths falling among women from 2015-2019 from 1.7 to 1.5 per 100,000 people. From 2012-2019, suicides by drug overdose among men fell from 1.6 to 1.2 per 100,000 people. While intentional overdose deaths fell among both men and women, there were more among women than men.

But young people, male and female, had more suicides by drug overdoses. More intentional overdose deaths were reported by Black women of all ages and both older men and older women.

Here are the groups with more reported suicides by drug overdoses:

• Young males ages 15 to 24 (rose from 0.6 per 100,000 people in 2015 to 0.8 in 2019);
• Young females ages 15 to 24 (increased from 0.6 per 100,000 people in 2014 to 1.0 in 2019);
• Older men ages 75 to 84 (rose from 0.7 per 100,000 people in 2001 to 1.6 in 2019);
• Older women ages 75 to 84 (increased from 0.8 per 100,000 people in 2001 to 1.7 in 2019), and;
• Black women (rose from 0.4 per 100,000 people in 2013 to 0.7 in 2019).

When they are occurring

Most intentional drug overdose deaths occur in late spring or summer, the researchers found, while the lowest rates were recorded in December. The researchers speculated feelings of hope during the holidays may be a factor.

As for the uptick in late spring and summer, the study suggested it could be tied to longer daylight hours leading to more availability of molecules in the brain known as mu opioid receptors. These receptors affect mood and are targets of opioid drugs, the most common drugs used in suicides, the researchers noted.

Monday is the day most intentional overdose deaths occur, while they are less likely on weekends, the study found.

Implications

Emily Einstein, chief of NIDA’s science policy branch and an author on the study, said it’s important to gain a sense of patients’ support system and other environmental factors in assessing suicide risk.

Doctors may need to do repeated evaluations of those at risk.

“The risk of intentional overdoses, and suicide risk in general, is not static. This is crucial for clinicians to keep in mind, as they may need to assess patients’ suicide risk frequently rather than at one point in time,” Einstein said in a statement.

“It is also important for friends and family members of people who may be at an increased risk of suicide, and for those people themselves, so that they can be aware of the greatest periods of risk and seek help when needed.”

The researchers also noted that the COVID-19 pandemic could be affecting some trends and is worthy of additional study.

Help is available

If you're struggling or someone you know is struggling, help is available around the clock through the National Suicide Prevention Hotline. Call 800-273-TALK (8255).