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Poisoning deaths among late-middle aged and older adults: comparison between suicides and deaths of undetermined intent

Published online by Cambridge University Press:  24 October 2018

Namkee G. Choi ,
Diana M. DiNitto ,
C. Nathan Marti  and
Bryan Y. Choi
Namkee G. Choi*
Affiliation:
The University of Texas at Austin Steve Hicks School of Social Work, Austin, TX, USA
Diana M. DiNitto
Affiliation:
The University of Texas at Austin Steve Hicks School of Social Work, Austin, TX, USA
C. Nathan Marti
Affiliation:
The University of Texas at Austin Steve Hicks School of Social Work, Austin, TX, USA
Bryan Y. Choi
Affiliation:
Department of Emergency Medicine, Brown University, Providence, RI, USA
*
Correspondence should be addressed to: Namkee G. Choi, 1925 San Jacinto Blvd, D3500, Austin, Texas 78712, U.S.A. Phone: 512-232-9590; Fax: 512-471-9600. Email: nchoi@austin.utexas.edu.
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Abstract

Background:

Given the rapid increase in prescription and illicit drug poisoning deaths in the 50+ age group, we examined precipitating/risk factors and toxicology results associated with poisoning deaths classified as suicides compared to intent-undetermined death (UnD) among decedents aged 50+.

Methods:

Data were from the 2005–2015 US National Violent Death Reporting System (N = 15,453). χ2 tests and multinomial logistic regression models were used to compare three groups of decedents: suicide decedent who left a suicide note, suicide decedent who did not leave a note, and UnD cases.

Results:

Compared to suicide decedents without a note (37.7% of the sample), those with a note (29.4%) were more likely to have been depressed and had physical health problems and other life stressors, while UnD cases (32.9%) were less likely to have had mental health problems and other life stressors but more likely to have had substance use and health problems. UnD cases were also more likely to be opioid (RRR = 2.65, 95% CI = 2.42–2.90) and cocaine (RRR = 2.59, 95% CI = 2.09–3.21) positive but less likely to be antidepressant positive. Blacks were more than twice as likely as non-Hispanic Whites to be UnDs. Results from separate regression models in the highest UnD states (Maryland and Utah) and in states other than Maryland/Utah were similar.

Conclusions:

Many UnDs may be more correctly classified as unintentional overdose deaths. Along with more accurate determination processes for intent/manner of death, substance use treatment and approaches to curbing opioid and other drug use problems are needed to prevent intentional and unintentional poisoning deaths.

Keywords

suicideintent-undetermined deathalcohol and substance usepost-mortem toxicology testing
Type
Original Research Article
Information
International Psychogeriatrics , Volume 31 , Issue 8: Issue Theme: Dementia Care , August 2019 , pp. 1159 - 1169
Copyright
© International Psychogeriatric Association 2018 

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