Suicide by non-pharmaceutical poisons in San Diego County

In 2010, 6,599 poisoning suicides were reported in the United States (US). While medications remain the primary substances involved in completed poisoning suicides, successful fatal poisonings with non-pharmaceutical substances occur with some regularity. The goal of this study was to identify successful suicides caused by non-pharmaceutical self-poisoning in a large US county over the last 12 years.

A large US-county medical-examiner's database was queried for all suicides in which exposure to non-pharmaceuticals was listed as the cause of death from 2000 to 2012. Substances were categorized by specific toxin when available and by product type when unavailable. Decedent age, sex, and circumstances surrounding each case were also reviewed.

Ages ranged from 18 to 95 (median 48) years. There were 159 (77%) males and 48 females. A total of 11 poisons were utilized.

Worldwide, intentional CO inhalation is a common method for committing suicide and intentional CO inhalation was the most common method of non-pharmaceutical self-poisoning suicide in our data. Other relatively common poisons including ethylene glycol and cyanide were employed in a relatively constant manner over time as well. Surprisingly, there have been an increasing number of helium-inhalation deaths in recent years.

Inhaled toxins are the most popular (81%) in non-pharmaceutical suicides, likely due to their rapidity of death. Although much less frequently, individuals successfully employ a broad spectrum of other toxins to commit suicide.