From Substance Use Disorders in Life to Autopsy Findings : A Combined Case-Record and Medico-Legal Study
(2019) In International Journal of Environmental Research and Public Health 16(5).- Abstract
Objectives: Several studies have shown mortality and suicide risk in substance use disorders, and autopsy findings with respect to the used substances. However, there seems to be a gap in the knowledge about substances misused in life and at death at the within-person level. Methods: All consecutive, autopsied patients during 1993 to 1997, who had been in contact with the Addiction Centre in Malmö from 1968, were investigated (365 subjects). Drug misuse in the long-term course noted in case records was related to autopsy findings. Self-inflicted death (suicide/undetermined suicide/accidental overdose) was compared with natural death. Results: Benzodiazepine misuse was associated with a high risk of autopsy findings of the substance in... (More)
Objectives: Several studies have shown mortality and suicide risk in substance use disorders, and autopsy findings with respect to the used substances. However, there seems to be a gap in the knowledge about substances misused in life and at death at the within-person level. Methods: All consecutive, autopsied patients during 1993 to 1997, who had been in contact with the Addiction Centre in Malmö from 1968, were investigated (365 subjects). Drug misuse in the long-term course noted in case records was related to autopsy findings. Self-inflicted death (suicide/undetermined suicide/accidental overdose) was compared with natural death. Results: Benzodiazepine misuse was associated with a high risk of autopsy findings of the substance in suicide and death of undetermined intent. It was also associated among non-misusers, but less so. An alcohol level above 1‰ was found more often in self-inflicted death. Prescription opioids at autopsy were mainly found in self-inflicted death among non-misusers. Heroin misuse was related to overdose. Central nervous system stimulants (CNS-S) and cannabis were rarely found in self-inflicted death among previous misusers. The overlap between depression in life and antidepressants at death was low. Conclusions: Benzodiazepines and alcohol seem to disinhibit suicidal tendencies. Suicide risk among users of cannabis and CNS-S may be related to other risk factors than acute use. Implications for suicide prevention are discussed.
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- author
- Brådvik, Louise LU ; Löwenhielm, Peter LU ; Frank, Arne LU and Berglund, Mats LU
- organization
- publishing date
- 2019-03-05
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- autopsy findings, case records, depression, substance use disorders, suicide risk
- in
- International Journal of Environmental Research and Public Health
- volume
- 16
- issue
- 5
- article number
- 801
- publisher
- MDPI AG
- external identifiers
-
- pmid:30841557
- scopus:85062637449
- ISSN
- 1660-4601
- DOI
- 10.3390/ijerph16050801
- language
- English
- LU publication?
- yes
- id
- e39e9506-a8d8-49f0-b6f9-274a882a519f
- date added to LUP
- 2019-03-19 12:56:45
- date last changed
- 2024-03-02 22:43:52
@article{e39e9506-a8d8-49f0-b6f9-274a882a519f,
abstract = {{<p>Objectives: Several studies have shown mortality and suicide risk in substance use disorders, and autopsy findings with respect to the used substances. However, there seems to be a gap in the knowledge about substances misused in life and at death at the within-person level. Methods: All consecutive, autopsied patients during 1993 to 1997, who had been in contact with the Addiction Centre in Malmö from 1968, were investigated (365 subjects). Drug misuse in the long-term course noted in case records was related to autopsy findings. Self-inflicted death (suicide/undetermined suicide/accidental overdose) was compared with natural death. Results: Benzodiazepine misuse was associated with a high risk of autopsy findings of the substance in suicide and death of undetermined intent. It was also associated among non-misusers, but less so. An alcohol level above 1‰ was found more often in self-inflicted death. Prescription opioids at autopsy were mainly found in self-inflicted death among non-misusers. Heroin misuse was related to overdose. Central nervous system stimulants (CNS-S) and cannabis were rarely found in self-inflicted death among previous misusers. The overlap between depression in life and antidepressants at death was low. Conclusions: Benzodiazepines and alcohol seem to disinhibit suicidal tendencies. Suicide risk among users of cannabis and CNS-S may be related to other risk factors than acute use. Implications for suicide prevention are discussed.</p>}},
author = {{Brådvik, Louise and Löwenhielm, Peter and Frank, Arne and Berglund, Mats}},
issn = {{1660-4601}},
keywords = {{autopsy findings; case records; depression; substance use disorders; suicide risk}},
language = {{eng}},
month = {{03}},
number = {{5}},
publisher = {{MDPI AG}},
series = {{International Journal of Environmental Research and Public Health}},
title = {{From Substance Use Disorders in Life to Autopsy Findings : A Combined Case-Record and Medico-Legal Study}},
url = {{http://dx.doi.org/10.3390/ijerph16050801}},
doi = {{10.3390/ijerph16050801}},
volume = {{16}},
year = {{2019}},
}