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Acute influence of alcohol, THC or central stimulants on violent suicide: a Swedish Population study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Forensic Medicine.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Forensic Medicine.
Department of Clinical Neuroscience, Karolinska Institutet.
Stockholm Dependency Center.
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2014 (English)In: Journal of Forensic Sciences, ISSN 0022-1198, E-ISSN 1556-4029, Vol. 59, no 2, 436-440 p.Article in journal (Refereed) Published
Abstract [en]

Alcohol and substance abuse in general is a risk factor for suicide, but very little is known about the acute effect in relation to suicide method. Based on information from 18,894 medico-legal death investigations, including toxicological findings and manner of death, did the present study investigate whether acute influence of alcohol, tetrahydrocannabinol (THC) or central stimulants (amphetamine and cocaine) was related to the use of a violent suicide method, in comparison with the non-violent method self-poisoning and alcohol/illicit drugs negative suicide decedents. Multivariate analysis was conducted and the results revealed that acute influence of THC was related to using the violent suicide method; jumping from a height (RR 1.62; 95%CI 1.01-2.41). Alcohol intoxication was not related to any violent method, while the central stimulants positive suicide decedent had a higher, albeit not significant, risk for several violent methods. The study contributes with elucidating suicide methods in relation to acute intoxication.

 

Place, publisher, year, edition, pages
2014. Vol. 59, no 2, 436-440 p.
National Category
Psychiatry
Identifiers
URN: urn:nbn:se:uu:diva-193294DOI: 10.1111/1556-4029.12353ISI: 000332307900020OAI: oai:DiVA.org:uu-193294DiVA: diva2:601792
Available from: 2013-01-30 Created: 2013-01-30 Last updated: 2017-12-06Bibliographically approved
In thesis
1. Substance Use and Violence: Influence of Alcohol, Illicit Drugs and Anabolic Androgenic Steroids on Violent Crime and Self-directed Violence
Open this publication in new window or tab >>Substance Use and Violence: Influence of Alcohol, Illicit Drugs and Anabolic Androgenic Steroids on Violent Crime and Self-directed Violence
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Interpersonal violence and suicide are major health concerns, leading to premature death, extensive human suffering and staggering monetary costs. Although violent behaviour has multiple causes, it is well known that acute substance intake and abuse increase the risks of both interpersonal and self-directed violence. This association is quite well established for alcohol, while a more ambiguous literature exists for other common drugs of abuse. For example, anabolic androgenic steroids (AAS), synthetic analogues to the “male” sex hormone testosterone are suggested to elicit violent and aggressive behaviour. Two studies (I and III) in the present thesis addressed the association between AAS use and being suspected or convicted of a violent crime among remand prisoners and in a general population sample, respectively. Further, using the case-crossover design to control for confounders stable within individuals, I also investigated the triggering (short-term risk) effect of alcohol and drugs such as benzodiazepines and AAS, on violent crime (Study II). Finally, a fourth study (IV) based on a large national forensic sample of suicide completers (n=18,894) examined the risk of using a violent, more lethal, suicide method, when under acute influence of alcohol, central stimulants or cannabis.

The results of this thesis suggested that AAS use in itself is not a proximal risk factor for violent crime; the observed risk is probably due to the co-occurrence of abuse of other substances. Alcohol is a strong triggering risk factor for violent crime, constant across males and females as well as individuals with or without behavioral and psychiatric vulnerability. Intake of high doses of benzodiazepines is associated with an increased risk for violent crime. Cannabis use is associated with an increased risk of using the lethal suicide method of jumping from a height. I conclude that mapping substance abuse patterns may inform violence risk assessment and treatment planning.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2013. 78 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 864
Keyword
Substance abuse, violent crime, violent suicide, anabolic androgenic steroids
National Category
Forensic Science
Identifiers
urn:nbn:se:uu:diva-193301 (URN)978-91-554-8590-0 (ISBN)
Public defence
2013-03-15, Fåhraeus, Rudbecklaboratoriet, Dag Hammarskjöldsväg 20, Uppsala, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2013-02-21 Created: 2013-01-30 Last updated: 2013-02-28Bibliographically approved

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Lundholm, LenaThiblin, Ingemar

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