190 Alaska Suicide Toxicology Project

Monday, June 5, 2017: 10:00 AM-10:30 AM
Eagle, Boise Centre
Deborah Hull-Jilly , Alaska Department of Health and Social Services, Anchorage, AK

BACKGROUND: In response to physical health and mental health symptoms, some people adopt self-medicating behaviors using alcohol, prescription medications, and illicit drugs, which can then put them at increased risk for suicidal ideation and self-harm. With the resurgence of heroin use and continued opioid pain reliever abuse along with other illicit drugs, suicide associated with drug misuse is a significant public and behavioral health problem as well as public safety.  In 2015, the Alaska Division of Public Health began forensic toxicology testing of specimens from all suicide decedents. Analyses included illicit and prescription drugs of abuse. Findings from this initial study indicated that alcohol (59%), marijuana (23%), and opiates (19%) were the most frequently identified substances and that more than half of decedents (59%) tested had alcohol and 1 or more drugs present. Frequent characteristics among decedents with positive toxicology results included history of mental health problem, intimate partner problem, and suicide thoughts/ideations.

METHODS: In 2016, supported by the funds from the Council of State and Territorial Epidemiologists, specimens from all suicide decedents were sent for forensic toxicology testing. Results entered into the Division of Public Health’s Alaska Violent Death Reporting System will be assessed to identify trends and patterns in substance use and precipitating circumstances and characteristics prior to death. Data analysis will include descriptive statistics summarized by counts, percentages, and rates. Findings will be compared to test results from the 2015 project results and to suicide decedents that were tested for substances of abuse during 2009 through 2014.

RESULTS: During 2016, specimens collected from 177 suicide decedents were sent to a contract forensic toxicology laboratory for postmortem analyses. Tests included alcohol, amphetamines, antidepressants, cocaine, marijuana, and opiates (including heroin and prescription analgesics). Final test results are still pending.

CONCLUSIONS: Data from the Alaska Violent Death Reporting System indicated that nearly two-thirds (62%) of all violent deaths in Alaska were suicides. Only 21% of suicide decedents were tested for substances of abuse during 2009 through 2014. Findings from Alaska’s suicide toxicology project will yield crucial information on the role of substances in the state’s suicide problem, as well as improving our understanding of health issues associated with drug use and assisting healthcare providers to evaluate patients and develop individualized strategies for prevention and care.