NDARC Technical Report No. 100 (2000)
A sample of 223 methadone maintenance patients were interviewed about attempted suicide and heroin overdose histories. Forty percent of participants reported a history of at least one suicide attempt. Females were significantly more likely than males to have attempted suicide (50% v 31%), and to have done so on more than one occasion (28% v 15%). Ten percent of participants had attempted suicide since enrolment in their current treatment, and 8% of participants had attempted suicide in the preceding 12 months. There was a large and significant difference between males and females in the onset of attempted suicide with females reporting an initial attempt, on average, six years before males (18.3 v 24.7 yrs). Amongst those who had attempted suicide the initiation of heroin use preceded the first suicide attempt in 55% of cases. Females were significantly more likely than males to have attempted suicide prior to the onset of heroin use (69% v 11%).
While heroin overdose was common among the sample (66%), the most common methods employed for suicide attempts were overdose of a non-opioid drug (21%) and slitting of wrists (20%). A deliberate heroin overdose as a means of attempted suicide was reported by 10% of participants. Thus, while 40% of participants had attempted suicide, only 10% of participants had done so by means of a deliberate heroin overdose. Those participants who had experienced an overdose were significantly more likely to have attempted suicide than other participants (46% v 28%). However, this is not surprising given that 10% of participants had employed heroin overdose as a means of suicide. When these were excluded from the analyses, those participants who had experienced a heroin overdose were no more likely to have attempted suicide than other participants. Overdoses appeared overwhelmingly to be accidental. Ninety two percent of those who had overdosed reported that their most recent overdose was accidental.
Attempted suicide presents a major clinical problem to staff at drug treatment programmes, which is distinct from the issue of heroin overdose. Most heroin overdoses appear to be accidental, and most suicide attempts employ other methods. While both overdose and suicide present increasing clinical problems, they are separate problems, and require different responses.