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Acute alcohol intoxication and suicide: a gender-stratified analysis of the National Violent Death Reporting System
  1. Mark S Kaplan1,
  2. Bentson H McFarland2,
  3. Nathalie Huguet3,
  4. Kenneth Conner4,5,
  5. Raul Caetano6,
  6. Norman Giesbrecht7,
  7. Kurt B Nolte8
  1. 1School of Community Health, Portland State University, Portland, Oregon, USA
  2. 2Department of Psychiatry, Oregon Health & Science University, Portland, Oregon, USA
  3. 3Center for Public Health Studies, Portland State University, Portland, Oregon, USA
  4. 4VA VISN 2 Center of Excellence for Suicide Prevention, Canandaigua, New York, USA
  5. 5Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA
  6. 6School of Public Health, University of Texas, Dallas, Texas, USA
  7. 7Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
  8. 8University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
  1. Correspondence to Dr Mark S Kaplan, Professor of Community Health, Portland State University, P.O. Box 751, Portland, OR 97207, USA; kaplanm{at}


Objectives Although it is well known that people with alcohol dependence are at a markedly elevated risk for suicide, much less is known about the role of acute alcohol use in suicidal behaviours. The primary aims of this epidemiological study were to assess the prevalence and factors associated with acute alcohol intoxication among 57 813 suicide decedents in 16 states.

Methods Data from the restricted National Violent Death Reporting System 2003–2009 for male and female suicide decedents aged 18 years and older were analysed by multiple logistic regression to compare decedents with and without acute alcohol intoxication (defined as blood alcohol concentration (BAC) ≥0.08 g/dl).

Results Among men, those who were younger, American Indian/Alaska Native, Hispanic, veterans, of lower educational attainment, deceased from a self-inflicted firearm injury or hanging/suffocation and residing in rural areas were more likely to have been intoxicated at the time of death. Among women, the factors associated with a BAC ≥0.08 g/dl were younger age, being American Indian/Alaska Native, and using a firearm, hanging/suffocation or falling as method of death.

Conclusions In both men and women, alcohol intoxication was associated with violent methods of suicide and declined markedly with age, suggesting that addressing risks associated with acute alcohol use may be of the greatest aid in the prevention of violent suicides among young and middle age adults.

  • Alcohol
  • intoxication
  • suicide
  • firearm
  • suicide/self-harm
  • health disparities
  • older people

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  • Funding This study was supported by grant R01 AA020063 from the National Institute on Alcohol Abuse and Alcoholism. All analyses, interpretations and conclusions based on the analysis of these data are solely the responsibility of the authors.

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the Portland State University Human Subjects Research Review Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.