Postmortem presence of drugs and method of violent suicide

The link between substance use and suicide is well established. However, little research analyzes how substance use is related to the method of suicide. This article analyzes how specific drugs are associated with method of suicide, a critical topic because drug use bears on the etiology of suicide and may lead to policies aimed at deterring suicide. We use the Colorado Violent Death Reporting System and logistic regression to examine postmortem presence of drugs among 3,389 hanging and firearm suicides in Colorado from 2004 to 2009. Net of demographic controls, we find that opiates are positively associated with firearms (odds ratio [OR] = 1.92, 95% confidence interval [CI] = [1.27, 2.86]) while antidepressants are positively associated with hanging (OR = 1.45, 95% CI = [1.04, 2.03]). For cocaine and opiates, the association between drug use and violent method vary by educational attainment. Importantly, knowledge of the presence and type of specific drug is strongly associated with the method of suicide.