Suicide rates in the U.S. seriously underestimated because “drug intoxication suicides” are misclassified, according to public health expert

Suicide rates in the U.S. have increased over the past decade, according to data from the Centers for Disease Control and Prevention (CDC). Between 2000 to 2016, it jumped by 34 percent — a high point, according to experts. However, a study made by a team of researchers from West Virginia University states that this number is “seriously underestimated.”

The study, titled Discerning Suicide in Drug Intoxication Deaths: Paucity and Primacy of Suicide Notes and Psychiatric History, focused on drug suicide rates. In particular, researchers state that their estimated number of recorded suicides may be lower than the actual rate, since a lot of these deaths may be misclassified as “accidental” or “undetermined.” These cases, according to researchers, muddle the actual number of drug-related suicide cases.

“There is a serious problem of suicide undercounting in the United States, which stems from the opioid epidemic and under-resourcing of emergency healthcare and death investigation systems,” lead author Ian Rockett explained. “Our analysis of data from the CDC’s National Violent Death Reporting System shows detection of drug intoxication suicides is highly dependent upon authenticated suicide notes and psychiatric histories. This information is often minimal or nonexistent, which impedes both suicide understanding and prevention.”

Suicide is a topic that’s highly regarded as taboo. The stigma that it carries, along with other factors, make this issue underrated and, most importantly, undercounted. In the study, the team identified the leading methods of suicide, which included firearms (gunshot wound), hanging or suffocation, and drug intoxication. These three causes made up the majority of suicide cases in 2015 alone.

However, researchers posited that drug-related suicide cases present more challenging circumstances than others. In particular, self-inflicted gunshot wounds and hanging are easier to identify since they are more pronounced. For drug-related cases, however, they believe that suicide notes and psychiatric history, which include previous suicide attempts and diagnosed depression, are better ways of determining drug-intoxicated suicide.

For the study, researchers looked at data from the National Violent Death Reporting System (NVDRS) Restricted Access Database, which provides detailed, individual-level information regarding violent deaths (including suicide). The team gathered data on deaths caused by intentional self-harm and undetermined deaths, studying demographics and underlying factors regarding it.

The research team found that only one-third of suicide cases and a quarter of undetermined deaths have a suicide note, prior suicide attempt, or an affective disorder noted. This increases the likelihood of probable drug intoxication cases to be classified as undetermined (or even accidental), rather than suicide. This is aggravated by the presence of pharmaceutical opioids and illegal opioids in drug fatalities, as well as a “highly stressed” emergency hotline system. (Related: Suicide rates double with antidepressants; drugs being handed out like candy.)

“Without this evidence, we are significantly underestimating suicide as a clinical and public health problem,” Rockett quipped. “We need to more accurately identify all types of self-injury behaviors to ensure we are providing appropriate treatment, education and prevention programs.”

The CDC considers suicide as a “serious public health problem.” Formally, suicide is defined as the condition where people engage in direct violence with the intention of ending their lives. In the U.S., suicide is one of the leading causes of death. Based on the study, suicide rates are highest between the ages of 15 to 54 years old.

If you (or anyone you know) are dealing with issues related to suicide, you can call the National Suicide Prevention Hotline at 1-800-273-TALK (8255).

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