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Sodium azide/nitrite suicides in the Netherlands between 2015 and 2022
Karen E van den Hondel1, Dominique van Pelt2, Lizanne Schweren2
1Public Health Service, Department of Forensic Medicine, Amsterdam, the Netherlands.
Journal of Forensic and Legal Medicine
|February 24, 2025
Summary
A rise in sodium azide and sodium nitrite suicides was observed in the Netherlands between 2017 and 2022. These suicides were more common in older females, many with a history of psychiatric illness.
Area of Science:
- Forensic Toxicology
- Public Health
- Epidemiology
Background:
- A right-to-die organization publicized sodium azide and sodium nitrite as suicide methods in 2017.
- This led to an increase in the use of these chemicals for self-harm.
Purpose of the Study:
- To investigate the number and characteristics of deaths by sodium azide and sodium nitrite suicide in the Netherlands from 2015 to 2022.
- To compare these suicides with overall suicide rates and suicides by self-poisoning.
Main Methods:
- Observational study using external examination reports from forensic physicians and data from Statistics Netherlands.
- Analysis of 172 identified cases of sodium azide and sodium nitrite suicides between 2015 and 2022.
- Toxicologic screening confirmed 12% of cases.
Main Results:
- 172 suicides involving sodium azide or sodium nitrite were identified between 2015-2022, with the first case in 2017.
- Individuals were equally male/female, 38% were over 70, and 70% had a history of psychiatric illness.
- Suicides by these agents increased from 2017, peaking in 2021, and were more prevalent in females and older individuals compared to general suicides.
Conclusions:
- A notable increase in sodium azide and sodium nitrite suicides occurred in the Netherlands since 2017.
- These suicides disproportionately affect older females, often with pre-existing psychiatric conditions.
- Further research into individual characteristics is crucial for developing targeted suicide prevention strategies.
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