Suicidal intent in non-fatal illicit drug overdose

Aim. To explore suicidal intent among drug users experiencing non-fatal ove rdose. Design. Semi-structured interviews. Setting and participants. Sevent y-seven drug users experiencing non-fatal overdose and attending six hospit al accident and emergency departments in two Scottish cities during 1997 an d 1998. Measurements. The extent of suicidal intent and motivations for int entional overdosing were examined. Findings. The incidence of suicidal inte nt was high, with 38 respondents (49%) reporting suicidal thoughts or feeli ngs before overdosing. Suicidal actions were significantly associated with a self-reported history of life-time mental health problems and with not us ing heroin prior to overdosing, but not with other demographic or drug hist ory data. Qualitative data indicated that intentional overdosing was freque ntly not driven by a clear and unambiguous desire to die. Furthermore, suic idal actions were motivated by a range of psychosocial factors, including: (i) predisposing personal circumstances; (ii) precipitating events; and (ii i) poor individual coping strategies. Conclusions. The issue of suicidal in tent needs to be addressed routinely in hospital wards and accident and eme rgency departments so that the need for support can be assessed.