The relationship between suicide and heroin overdose among methadone maintenance patients in Sydney, Australia

Aims. To examine the relationship between attempted suicide and non-fatal h eroin overdose among methadone maintenance patients. Design. Cross-sectiona l survey. Setting. Sydney, Australia. Participants. Two hundred and twenty- three methadone maintenance patients. Findings. Forty per cent of participa nts reported a history of at least one suicide attempt. Females were signif icantly more likely than males to have attempted suicide (50% vs. 31%), and to have done so on more than one occasion (28% vs. 15%). There was a large difference between males and females in the onset of attempted suicide. Fe males reported an initial attempt, on average, 6 years earlier than males ( 18.3 vs. 24.7 years), and were significantly more likely than males to have attempted suicide prior to the onset of heroin use (69% vs. 11%). While he roin overdose was common among the sample (66%), the most common methods em ployed for suicide attempts were overdose of a non-opioid drug (21%) and sl itting of wrists (20%). A deliberate heroin overdose as a means of attempte d suicide was reported by 10% of participants. Heroin overdoses appeared ov erwhelmingly to be accidental. Ninety-two per cent of those who had overdos ed reported that their most recent overdose was accidental. Conclusions. At tempted suicide presents a major clinical problem to staff at drug treatmen t programmes, but one distinct from heroin overdose. While both overdose an d suicide present increasing clinical problems, they are separate problems, and require different responses.