Drug and Alcohol Dependence

Volume 87, Issues 2-3, 16 March 2007, Pages 146-152

Patterns and correlates of attempted suicide by heroin users over a 3-year
period: Findings from the Australian treatment outcome study
Shane Darke, a, , oanne !ossa, "nna #$ll$amsona, %a&her$ne '( M$llsa, "l)s
*a+ar,a an, Maree -eessona
a.a&$onal Drug an, "lcohol !esearch /en&re, 0n$+ers$&) o1 .e2 Sou&h #ales,
.S# 2052, "us&ral$a
"3s&rac&
In or,er &o ,e&erm$ne 4a&&erns an, correla&es o1 a&&em4&e, su$c$,e amongs& hero$n
users across 3 )ears, a cohor& o1 387 hero$n users 5134 en&er$ng ma$n&enance
&rea&men&, 134 en&er$ng ,e&o6$1$ca&$on, 81 en&er$ng res$,en&$al reha3$l$&a&$on an, 38
no& en&er$ng &rea&men&7 2ere $n&er+$e2e, a3ou& su$c$,e a&&em4&s a& 3asel$ne, 12, 24
an, 36 mon&hs( "cross &he 1ollo2-u4 4er$o,, 11(68 a&&em4&e, su$c$,e( -here 2ere
,ecl$nes $n &he 4ro4or&$on 2ho a&&em4&e, su$c$,e each )ear amongs& 3o&h males
an, 1emales an, s$gn$1$can& ,ecl$nes $n Ma9or De4ress$on, su$c$,al $,ea&$on an,
curren& su$c$,e 4lans( Des4$&e &h$s, le+els o1 a&&em4&e, su$c$,e, su$c$,al $,ea&$on
an, Ma9or De4ress$on $n &he cohor& rema$ne, h$gher &han $n &he general 4o4ula&$on(
-hose 2ho ha, ma,e a 4re+$ous su$c$,e a&&em4& 2ere 1$+e &$mes more l$kel) &o
make an a&&em4& across 1ollo2-u4 an, &here 2as a s&rong assoc$a&$on 3e&2een an
a&&em4& $n an) 1 )ear an, $ncrease, 4ro3a3$l$&) o1 an a&&em4& $n &he su3se:uen&
)ear( " :uar&er o1 &hose 2ho re4or&e, su$c$,al $,ea&$on a& 3asel$ne ma,e an a&&em4&
across 1ollo2-u4( "& each $n&er+$e2 4o$n&, curren& su$c$,al $,ea&$on 2as s&rongl)
assoc$a&e, 2$&h $ncrease, r$sk o1 a su$c$,e a&&em4& $n &he 1ollo2$ng )ear(
In,e4en,en& 4re,$c&ors o1 a su$c$,e a&&em4& across 1ollo2-u4 2ere a l$1e&$me
su$c$,e h$s&or), 3asel$ne su$c$,al $,ea&$on, soc$al $sola&$on an, &he e6&en& o1 3asel$ne
4ol),rug use( ;$+en &he s&rong 4re,$c&$+e +alue o1 su$c$,al $,ea&$on an, 4re+$ous
a&&em4&s, regular 3r$e1 screen$ng 2oul, a44ear 2arran&e, &o $,en&$1) &hose a&
grea&es& r$sk(
ournal o1 Su3s&ance "3use
1<<<, Vol( 4, .o( 2, Pages 88-<1
Heroin overdose among a treatment sample of injecting drug misusers:
accident or suicidal behaviour?
'( V$ngoe 1, S( #elch 1, M( =arrell 1, ( S&rang 1, 'ou$sa V$ngoe 1, Sarah #elch 2,
M$chael =arrell 3 an, ohn S&rang
>+er,ose $s a common cause o1 4rema&ure ,ea&h $n o4$a&e m$susers( Su3s&ance
m$suse $s kno2n &o $ncrease &he r$sk o1 com4le&e, su$c$,e( -he rela&$onsh$4
3e&2een ?non-$n&en&$onal o+er,oses@ an, ?$n&en&$onal o+er,oses@ or su$c$,es $s
unclear( In or,er &o $n+es&$ga&e &h$s rela&$onsh$4 a sem$-s&ruc&ure, $n&er+$e2
$n+es&$ga&$ng &he h$s&or) o1 hero$n o+er,ose an, su$c$,al &hough&s an, 3eha+$our
2as un,er&aken 2$&h 48 $n9ec&$ng ,rug m$susers a&&en,$ng a Sou&h 'on,on
commun$&)-3ase, &rea&men& cen&re( =$1&)-1our 4ercen& ha, 4re+$ousl) o+er,ose, on
hero$n, an, 358 ha, ma,e a su$c$,e a&&em4&( " h$s&or) o1 su$c$,e a&&em4&s an,
h$s&or) o1 hero$n o+er,ose 2ere s$gn$1$can&l) assoc$a&e,( *o2e+er, hero$n o+er,ose
as a means o1 a&&em4&$ng su$c$,e 2as uncommon, 2$&h &he ma9or$&) re4or&$ng
o+er,ose 3) use o1 o&her ,rugs( I& $s conclu,e, &ha& hero$n o+er,ose an, h$s&or) o1
su$c$,e a&&em4&s 2ere 3o&h common( "l&hough hero$n o+er,ose 2as sel,om chosen
as a su$c$,e me&ho,, &he 1$n,$ngs sugges& &ha& &he r$sks o1 non-$n&en&$onal hero$n
o+er,ose an, o1 su$c$,e o+erla4((
Addiction. 2002 Nov;97(11):1383-94.
uicide among heroin users: rates! ris" factors and methods#
Darke S, !oss (
.a&$onal Drug an, "lcohol !esearch /en&re, 0n$+ers$&) o1 .e2 Sou&h #ales,
"us&ral$a(
"3s&rac&
-he curren& 4a4er e6am$nes cr$&$call) &he l$&era&ure on su$c$,e ra&es, su$c$,e r$sk
1ac&ors an, me&ho,s em4lo)e, 1or su$c$,e among hero$n users, an, com4ares &hese
&o &hose o1 &he general 4o4ula&$on( *ero$n users ha+e a ,ea&h ra&e 13 &$mes &ha& o1
&he$r 4eers, an, ,ea&hs among hero$n users a&&r$3u&e, &o su$c$,e range 1rom 3-358(
>+erall, hero$n users are 14 &$mes more l$kel) &han 4eers &o ,$e 1rom su$c$,e( -he
4re+alence o1 a&&em4&e, su$c$,e $s also man) or,ers o1 magn$&u,e grea&er &han &ha&
o1 commun$&) sam4les( -he ma9or general 4o4ula&$on r$sk 1ac&ors 1or su$c$,e also
a44l) &o hero$n users 5gen,er, 4s)cho4a&holog), 1am$l) ,)s1unc&$on an, soc$al
$sola&$on7( *ero$n users, ho2e+er, ha+e e6&remel) 2$,e e64osure &o &hese 1ac&ors(
-he) also carr) a,,$&$onal r$sks s4ec$1$call) assoc$a&e, 2$&h hero$n an, o&her ,rug
use( Drugs as a me&ho, o1 su$c$,e 4la) a larger role $n su$c$,e among hero$n users
&han $n &he general 4o4ula&$on( *ero$n, ho2e+er, a44ears &o 4la) a rela&$+el) small
role $n su$c$,e among &h$s grou4( >+erall, su$c$,e $s a ma9or cl$n$cal $ssue among
hero$n users( I& $s conclu,e, &ha& su$c$,e $s a ma9or 4ro3lem &ha& &rea&men& agenc$es
1ace, an, 2h$ch re:u$res &arge&e, $n&er+en&$on $1 &he ra&es o1 su$c$,e among &h$s
grou4 are &o ,ecl$ne(
PMIDA 1241077< BPu3Me, - $n,e6e, 1or MCD'I.CD
British Journal of Addiction to Alcohol & Other Drugs
Volume 62 Issue 3-4, ages 3!" - 3!#
$uicide and %ortalit& Amongst 'eroin Addicts in Britain(
I. PIERCE JAMES M.A., M.B., D.P.M.

*Based on a paper read at the London Committee for the Stud of Dru! Addi"tion Conferen"e on #eroin
and Co"aine Addi"tion on $% &e'ruar ()**.

+ootin! Bee #ospita,, London
AB$)*A+)
+he 'a"-!round to the "urrent pra"ti"e of dea,in! .ith heroin addi"ts in /reat Britain is 'rief, sur0eed.
+he morta,it rate amon!st heroin addi"ts first addi"ted from i,,i"it sour"es of heroin .as found to
appro1imate to $$ per (222 per ear 3a fi!ure near, t.ent times that of the e1pe"ted rate and pro'a',
hi!her than amon!st nar"oti" addi"ts in the 4.S.A.5. 6f 78 deaths amon!st 7$( ma,e heroin addi"ts, )
deaths 3at a mean a!e of $)9( ears5 .ere from sui"ide: ($ deaths 3mean a!e $*9) ears5 resu,ted from
a""identa, dru! o0erdose and there .ere (; deaths 3mean a!e 7*98 ears5 from other "auses.
Sui"ida, impu,ses often o""ur durin! periods of dru!<.ithdra.a, and ; of the addi"ts died in prison.