People who use cocaine and amphetamines face almost two-fold greater risk of suicidal behaviour between people who inject drugs.
The groundbreaking study by researchers at the University of Montreal and the CHUM Research Centre could help develop and evaluate more appropriate suicide prevention efforts in this highly vulnerable population.
The researchers were able to explore the relationship between substance abuse and risk of suicidal behaviour by studying in detail the different types of substances used among more than 1,200 people who inject drugs (PWIDs).
They used data from the HEPCO Cohort to examine the individual and contextual factors associated with hepatitis C infection. The HEPCO cohort participants were 18 or older and had injected drugs in the past six months.
The findings indicated that suicide attempts are most common among PWIDs. At the beginning of the study, nearly 6 percent of participants had indeed reported a suicide attempt in the previous six months, a dramatically higher rate than the general population. During follow-up, 143 participants experienced at least one episode of attempted suicide. The researchers found that chronic and occasional use of stimulant drugs such as cocaine and amphetamines was associated with nearly two-fold greater odds of reporting an attempt than the use of other drugs to report a suicide attempt.
Surprisingly, however, they did not observe the same positive association with other substances, including opiates, which are nevertheless regarded as among the most damaging to health and psycho-social wellbeing.
According to the researchers, a set of neurobiological, behavioural and social differences between stimulant users and opiate users could explain these findings. Stimulant users were more vulnerable because they were more impulsive and characterized by changing moods. The researchers also pointed out that cocaine addiction treatments are virtually nonexistent - drug treatment programs are often structured around opiates or alcohol.
