Psychoactive substances in suicides - Comparison of toxicologic findings in two samples

The goal in this study was to assess if there is any constancy in detection s of psychoactive substances in consecutive suicides. Toxicologic findings in 179 suicides in San Diego County, California, between 1981 and 1982, and 333 suicides in Mobile County, Alabama, between 1990 and 1998, were compar ed. Alcohol was detected in about 30% of suicides in both samples. Abusable prescription psychoactive substances, i.e., benzodiazepines and opiates, w ere detected in one fifth of cases in both locations. Nonabusable prescript ion psychoactive substances, mainly antidepressants, were found in more sui cides in Mobile than in San Diego. Detection rates of different classes of psychoactive substances have not changed much in the past decade. Detection of alcohol, cocaine, or cannabis in about 40% of suicides supports the cli nical practice of discouraging consumption of these substances in depressed patients. Another challenge is the low rate of detection of antidepressant s in suicide, which suggests undertreatment of depression in suicides. Cont inued reporting of routine, comprehensive, toxicologic findings in suicides is useful to monitor patterns of use of psychoactive substances in this gr oup and to guide suicide prevention in clinical practice and public health policy.