Occupational Access to Pharmaceuticals and Drug Poisoning-related Suicides among US Workers

Healthcare practitioners and technical workers have the highest rates of poisoning-related suicide among major occupational groups, potentially due to their occupational access to and familiarity with pharmaceuticals. However, the role of occupation-specific pharmaceutical access in suicide method choice remains poorly understood. This study examined whether occupational access to pharmaceuticals is associated with an increased likelihood of suicide by drug poisoning versus other methods.

In this mortality case-control study, suicides involving drug poisonings were compared with non-drug poisonings (e.g., firearms) using data from the National Violent Death Reporting System between 2013 and 2023. Occupational access to pharmaceuticals was defined as having job-related access to medications and professional-level knowledge of medication use. Adjusted odds ratios with 95% confidence intervals were estimated using multivariable logistic regression models, stratified by biological sex, and adjusted for age, race/ethnicity, education level, and rurality.

Among decedents with occupational access to pharmaceuticals (n = 4,123), most were registered nurses (63.4%), physicians (15.8%), or pharmacists (6.3%). Compared with those without occupational pharmaceutical access, male and female decedents had higher odds of dying by drug poisoning suicide (males: OR = 1.7, 95% CI: 1.3-2.1; females: OR = 1.4, 95% CI: 1.2-1.6).

Occupational access to pharmaceuticals may influence suicide method choice among healthcare workers. These findings underscore the need for targeted prevention strategies that address access to and familiarity with medications in high-risk occupations.