Note how prevalent psych drugs are as a danger to kids.
Information on drug poisoning suicide deaths in the US is not available at a very granular level. However, the following table1 does give a breakdown of 2012 suicide drug poisoning deaths:
Method No. % Other and unspecified drugs, medicaments and biological substances 3,632 54.0% Other gases and vapours 1,003 14.9% Anti-epileptic, sedative-hypnotic, anti-parkinsonism and psychotropic drugs, not elsewhere classified 969 14.4% Narcotics and psychodysleptics [hallucinogens], not elsewhere classified 662 9.8% Non-opioid analgesics, antipyretics and anti-rheumatics 160 2.4% Organic solvents and halogenated hydrocarbons and their vapours 126 1.9% Other and unspecified chemicals and noxious substances 78 1.2% Alcohol 47 0.7% Other drugs acting on the autonomic nervous system 42 0.6% Pesticides 10 0.1% Total 6,729
According to the CDC1, 81% of intentional poisoning suicides were caused by drugs - both legal and illegal. The most commonly used drugs identified in drug-related suicides were psychoactive drugs, such as sedatives and antidepressants, followed by opiates and prescription pain medications1. Self-harm poisoning was the leading cause of emergency department visits for intentional injury in 20102. In 2011, it was estimated by SAMHSA3 that attempted suicide led to 228,366 emergency department (ED) visits. Almost all involved a prescription drug or over-the-counter medication. It is worth noting that with only 5,465 actually succeeding in suicide using drugs, it means there were 42 ED visits for every successful suicide. Sobering odds of success, and there are probably lots of attempts that don’t even end up in hospital. Most patients attempting drug-related suicide had some form of follow-up after their ED visit, with the outcomes of their ED visits as follows:
- 49% were admitted for inpatient hospital care (18.3% to an intensive or critical care unit [ICU]), 9% to a psychiatric unit, and 22% to other units including combination psychiatric/detox units)
- 25% were transferred to another health care facility for specialist treatment
- 7% were referred to detox/treatment
- 15% treated and discharged to home
Evidence suggests that alcohol had been ingested in around a third of people who died by suicide, and in 29% of those admitted to ED departments. In nearly two thirds of cases more than one drug was involved. Pain relievers were found to be involved in 38% of drug-related suicide attempts. Narcotic pain relievers were involved in over a third of that number, and cetaminophen products were involved in just under a third. Benzodiazepines (anti-anxiety drugs) were found to be involved in 29.3% of drug - related suicide attempts. Alprazolam (Xanax) and clonazepam each accounted for about a third. Antidepressants appeared in 19.6% of visits. About half of those visits involved an SSRI antidepressant such as citalopram, sertraline, or fluoxetine. Trazodone, a SARI antidepressant, was involved in about a quarter. Antipsychotics, as a whole, appeared in 12.9% of visits, with the vast majority being the newer types of atypical anti-psychotics e.g. Quetiapine. The American Association of Poison Control Centers (AAPCC)4 publishes data on phone calls they receive into their 55 centers which are designed to track the incidence of poison exposure (both intentional and unintentional) nationally. In 2012 they recorded 2,873 deaths by poisons (itself some way short of the figures provided by US Department of Health and Human Services for suicide alone), and the table below shows the drugs that appeared most frequently as the cause of death by poisoning. Top 25 substance categories associated with deaths reported by 55 U.S. Poison Centers 2012
Substance No. % Sedative/hypnotics/antipsychotics 377 14.1% Miscellaneous cardiovascular drugs 350 12.2% Opioids 255 8.9% Acetaminophen (paracetamol) in combination 183 6.4% Miscellaneous stimulants and street drugs 176 6.1% Acetaminophen (paracetamol) only 159 5.5% Miscellaneous alcohols 145 5.0% Miscellaneous antidepressants 126 4.4% Selective serotonin reuptake inhibitors 89 3.1% Miscellaneous antihistamines 69 2.4% Tricyclic antidepressants 69 2.4% Miscellaneous fumes/gases/vapors 67 2.3% Acetylsalicylic acid 65 2.3% Miscellaneous muscle relaxants 57 2.0% Miscellaneous anticonvulsants 56 1.9% Oral hypoglycemic 56 1.9% Non-nonsteroidal anti-inflammatory drugs 50 1.7% Miscellaneous unknown drug 44 1.5% Miscellaneous unknown drugs 44 1.5% Miscellaneous chemicals 33 1.1% Miscellaneous hormones and hormone antagonists 31 1.1% Anticonvulsants: gamma aminobutyric acid & analogs 29 1.0% Miscellaneous anticoagulants 23 0.8% Miscellaneous diuretics 23 0.8% Cannabinoids and analogs 20 0.7% Miscellaneous hydrocarbons 19 0.7%
It should be noted that these percentages from their source do not add up to 100% as they are only the top 25 causes. It should also be noted that the above figures each represent the number of mentions in cause of death, not number of deaths. Any one fatality may have had exposure to more than one substance. Indeed, consistent with data from SAMHSA, the breakdown of drugs shown for many of the fatalities reported by AAPCC showed more than one drug. Sources
- Centers for Disease Control and Prevention, Web-based Injury Statistics Query and Reporting System (WISQARS), fatal injuries report figures (http://webappa.cdc.gov/sasweb/ncipc/leadcaus10_us.html).
- National Hospital Ambulatory Medical Care Survey: 2010 Emergency Department Summary Tables (10 and 17) (www.cdc.gov/nchs/data/ahcd/nhamcs_emergency/2010_ed_web_tables.pdf). See also Centers for Disease Control and Prevention, National Center for Injury Prevention and Control (NCIPC), Prescription Drug Overdose in the United States: Fact Sheet www.cdc.gov/homeandrecreationalsafety/overdose/facts.html.
- Substance Abuse and Mental Health Services Administration (SAMHSA), Office of Applied Studies. Drug Abuse Warning Network (DAWN): National estimates of drug-related emergency department visits for 2011, Table 22 (www.samhsa.gov/data/sites/default/files/DAWN2k11ED/DAWN2k11ED/DAWN2k11ED.pdf).
- James B Mowry, PHARMD; Daniel A Spyker PHD, MD; Louis R Cantilena JR, MD, PHD; J Elise Bailey MSPH; and Marsha Ford MD; 2012 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 30th Annual Report, Clinical Toxicology vol. 51 Oct 2013 (available from www.aapcc.org/annual-reports).