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Stimulant use in suicides: A systematic review.

Dylan Mantinieks1, Jennifer Schumann1, Olaf H Drummer1

  • 1Department of Forensic Medicine, School of Public Health and Preventive Medicine, Monash University, 65 Kavanagh Street, Southbank, 3006 Victoria, Australia; Victorian Institute of Forensic Medicine, 65 Kavanagh Street, Southbank, 3006, Victoria, Australia.

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Summary

Synthetic stimulant use is increasingly linked to suicides globally. Post-mortem toxicology reveals over-representation of stimulants like cocaine and amphetamines in suicide cases compared to the general population.

Keywords:
AmphetaminesCentral nervous system stimulantsCocaineSuicideToxicology

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Area of Science:

  • Forensic toxicology and public health

Background:

  • Suicide is a major global health issue.
  • The rise in synthetic stimulant use may increase substance-related suicides.

Purpose of the Study:

  • To systematically review the association between stimulant use detected in post-mortem specimens and suicide.
  • To estimate the prevalence of stimulant use in suicide cases.

Main Methods:

  • Systematic review and narrative synthesis of studies.
  • Searched Medline, EMBASE, TOXLINE, and Scopus databases.
  • Included studies reporting post-mortem toxicology and stimulant use in suicides.

Main Results:

  • 26 studies contributed prevalence data.
  • Stimulant use (cocaine, caffeine, MDMA, amphetamine, methamphetamine, phentermine) was over-represented in suicides compared to the general population.
  • Stimulant-associated suicides have increased over time.

Conclusions:

  • Findings suggest mechanisms beyond acute toxicity link stimulants to suicide.
  • Further research using psychological autopsies and hair analysis is needed to understand chronic stimulant exposure's role in suicide burden.