Gender differences in the presence of drugs in violent deaths

Aims: To investigate differences in the presence of drugs, by gender, when considering deaths attributable to homicides and suicides. Design: Logistic regression analysis of mortality data collected by the Colorado Violent Death Reporting System. Participants and setting: A total of 5791 Colorado decedents who died of violent causes from 2004 to 2009. Measurement: Forensic pathologist autopsy data on drug presence at time of death, coded as present, not present or missing. Findings: Postmortem presence of drugs is associated strongly with the specific cause of violent death. Compared with suicide decedents, homicide decedents are significantly more likely to test positive for amphetamines [odds ratio (OR): 1.79; confidence interval (CI): 1.34, 2.39], marijuana (OR: 2.03; CI: 1.60, 2.58) and cocaine (OR: 2.60; CI: 2.04, 3.31), and are less likely to test positive for opiates (OR: 0.27; CI: 0.18, 0.39) and antidepressants (OR: 0.17; CI: 0.10, 0.28). When other drugs are controlled for the influence of alcohol is abated dramatically. The patterns of drug prevalence associated with homicide (particularly marijuana) are stronger among males; the patterns of drug prevalence associated with suicide are stronger among females. Conclusions: Suicide and homicide decedents are characterized by varying patterns of licit and illicit drug use that differ by gender. Drugs associated with homicide (marijuana, cocaine and amphetamines) are stronger among males, while drugs associated with suicide are stronger among females (antidepressants and opiates). Taking these differences into consideration may allow for targeted interventions to reduce violent deaths.