Table 2

Alcohol and drug toxicology findings among suicide decedents

Period/geography/populationSuicide decedents (n)Toxicology: alcohol or other drugs
Isaacs et al341981–1996
Northwest Territories
78
  • Alcohol toxicology available for 78% of decedents.

  • Of these, 43% had positive BAC level at time of death, 33% with an impaired level.

  • Drug screens available for 47%, and 22% were positive for cannabinoids.

Poulin et al631993–1995
Halifax deaths investigated by the medical examiner
20
  • 42 (6.6%) deaths were due to drug overdose.

  • 20 (47.6%) overdose deaths were suicide deaths.

  • BAC positive in 20 of 42 (47.6%) overdose deaths.

Wilkie et al351995
Northern Manitoba suicide cluster
6
  • 4 (67%) decedents had alcohol or cannabinoids detected at time of death.

Bourget et al641991–1998
Quebec spousal homicide offender suicide deaths
58
  • 5.2% of offenders who killed their spouse and subsequently died by suicide were intoxicated at the time.

Bullock and Diniz71993–1997
Ontario plastic bag suffocation suicide deaths
110
  • 68 decedents screened for alcohol and drugs, 9 for alcohol only.

  • Of the 77 screened for alcohol, 27 (35%) were positive, 11 (14%) >100 mg%.

  • 39 (57%) decedents screened positive for drugs above a therapeutic level.

Mitic and Greschner361996–2000
British Columbia children and youth suicide deaths
34
  • Alcohol present at time of death in 32% of deaths.

  • Alcohol mentioned in fatality report in 71% of deaths.

Langman et al512000–2003
British Columbia quetiapine poisoning suicide deaths
3
  • 1 case due to mixed drug overdose, including codeine and morphine.

  • No alcohol reported among 3 deaths.

Shaw et al371993–2002
Hamilton youth suicide deaths
31
  • Toxicology available for 23 deaths.

  • Alcohol or drugs detected in 9 (29%) of deaths.

Bourget and Gagné651991–2001
Quebec paternal filicide offender suicide deaths
26
  • Only 3 (5%) offenders used drugs or alcohol at time of filicide, unclear if this was among those who died by suicide.

  • Not clear if this is based on toxicology.

Albion et al522004
Ontario methadone toxicity deaths
3
  • Evidence of suicidal intent in 3 out of 45 deaths reviewed.

  • 2 (67%) suicide deaths were due to illegal methadone.

  • 1 (33%) case also had positive BAC.

Sinyor et al381998–2007
Toronto poisoning suicide deaths
397
  • Substances causing death: alcohol in 10% of deaths; opioid analgesics in 28%; sedative/hypnotic/anxiolytic in 26%; tricyclic antidepressants in 20%.

  • Non-lethal substances detected in 55% of deaths.

Madadi et al402006–2008
Ontario suicide and accidental poisoning deaths
585
  • 214 opioid-involved suicide poisoning deaths and 371 suicide poisoning deaths not involving opioids.

  • Codeine was present in a higher proportion of opioid-related suicide deaths vs accidental opioid-related deaths.

Sinyor et al662003–2009
Toronto suicide deaths with a holograph* or will
1565
  • 15 of 59 deaths by suicide with holograph or will content had toxicology performed.

  • Alcohol present in 9 deaths, opioids in 8, sedative-hypnotic in 8, and other recreational in fewer than 5, 10 multiple drugs present.

Mishara and Bardon391999–2008
Canada railway suicide deaths
428
  • 100% of deaths had blood toxicology available.

  • 45.8% of those who died by suicide had alcohol or drugs in their blood.

Gomes et al411993–2013
Ontario opioid-related deaths
1197
  • 16% of suicide poisoning deaths by opioids were alcohol-involved, similar to the proportion of accidental poisoning deaths by opioids that were alcohol-involved (18%).

Schaffer et al491998–2012
Ontario suicide deaths among people with and without bipolar disorder
3319
  • Toxicology available for 93% of BD group and 85% of the non-BD group.

  • 39% of BD group had positive BAC, 14% of this group had an illegal drug present.

  • 43% of non-BD group had positive BAC, 11% had an illegal drug present.

  • Between 5% and 10% had lethal levels of alcohol present.

Solbeck et al532012–2015
Ontario phenobarbital self-poisoning suicide deaths
20
  • Among those who died of phenobarbital overdose, 3 had positive BAC without evidence of neoformation†.

Hawkins et al501998–2012
Ontario self-poisoning suicide deaths
3616
  • 33% of those with CVD who died by self-poisoning had alcohol present, compared with 46% of non-CVD self-poisoning suicide decedents.

  • *Holographs are wills that are entirely handwritten by the testator.

  • †Neoformation is the generation of alcohol that is the result of bacterial postmortem decomposition.

  • BAC, blood alcohol; BP, bipolar disorder; CVD, cardiovascular disease.