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Substance use issues preceding suicide : A Swedish nationwide record review

Doering, Sabrina ; Jonson, Mattias ; Ernback Schön, Klara ; Lindström, Sara LU orcid ; Ehnvall, Anna LU ; Wiktorsson, Stefan ; Stefenson, Anne ; Westrin, Åsa LU and Waern, Margda (2025) In Drug and Alcohol Dependence 274.
Abstract

Background: Substance use disorder (SUD) is associated with elevated suicide risk. The aim was to compare health care contacts as well as clinical and suicide-specific characteristics in individuals with and without substance use issues who died by suicide. Methods: Data were derived from a nationwide medical record review of confirmed suicides in Sweden. In the current study we included individuals with at least one physician contact in the last year of life (N = 956). Substance use issues were defined as either a SUD diagnosis, physician notations of ongoing substance use, or a prescription for SUD medication. Results: Substance use issues were found in 21 % of the total cohort. Individuals with substance use issues were more likely... (More)

Background: Substance use disorder (SUD) is associated with elevated suicide risk. The aim was to compare health care contacts as well as clinical and suicide-specific characteristics in individuals with and without substance use issues who died by suicide. Methods: Data were derived from a nationwide medical record review of confirmed suicides in Sweden. In the current study we included individuals with at least one physician contact in the last year of life (N = 956). Substance use issues were defined as either a SUD diagnosis, physician notations of ongoing substance use, or a prescription for SUD medication. Results: Substance use issues were found in 21 % of the total cohort. Individuals with substance use issues were more likely to have notations of social stressors. Depressive disorders were recorded in 23 % of the total cohort with no differences between those with and without substance use issues. Anxiety disorders were more common in individuals with substance use issues, as were notations of depressive symptoms and anxiety. In the final month of life, 66 % in the substance use group saw a psychiatrist, but fewer consulted GPs (29 %). Suicide risk was noted in 25 % of individuals with substance use issues, and in 15 % of those without. Conclusions: Many individuals with substance use issues were not identified as suicidal despite frequent healthcare contact, underscoring gaps in risk recognition. Improving risk management requires better training for professionals and enhanced collaboration between healthcare providers to address these complex needs.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Alcohol use disorder, Medical records, Mental health, Opioid use disorder, Substance use disorder, Suicide
in
Drug and Alcohol Dependence
volume
274
article number
112736
publisher
Elsevier
external identifiers
  • scopus:105007242666
  • pmid:40482518
ISSN
0376-8716
DOI
10.1016/j.drugalcdep.2025.112736
language
English
LU publication?
yes
id
bd100707-518f-413d-a47f-6365befc7de6
date added to LUP
2025-07-18 10:19:34
date last changed
2025-07-19 03:18:30
@article{bd100707-518f-413d-a47f-6365befc7de6,
  abstract     = {{<p>Background: Substance use disorder (SUD) is associated with elevated suicide risk. The aim was to compare health care contacts as well as clinical and suicide-specific characteristics in individuals with and without substance use issues who died by suicide. Methods: Data were derived from a nationwide medical record review of confirmed suicides in Sweden. In the current study we included individuals with at least one physician contact in the last year of life (N = 956). Substance use issues were defined as either a SUD diagnosis, physician notations of ongoing substance use, or a prescription for SUD medication. Results: Substance use issues were found in 21 % of the total cohort. Individuals with substance use issues were more likely to have notations of social stressors. Depressive disorders were recorded in 23 % of the total cohort with no differences between those with and without substance use issues. Anxiety disorders were more common in individuals with substance use issues, as were notations of depressive symptoms and anxiety. In the final month of life, 66 % in the substance use group saw a psychiatrist, but fewer consulted GPs (29 %). Suicide risk was noted in 25 % of individuals with substance use issues, and in 15 % of those without. Conclusions: Many individuals with substance use issues were not identified as suicidal despite frequent healthcare contact, underscoring gaps in risk recognition. Improving risk management requires better training for professionals and enhanced collaboration between healthcare providers to address these complex needs.</p>}},
  author       = {{Doering, Sabrina and Jonson, Mattias and Ernback Schön, Klara and Lindström, Sara and Ehnvall, Anna and Wiktorsson, Stefan and Stefenson, Anne and Westrin, Åsa and Waern, Margda}},
  issn         = {{0376-8716}},
  keywords     = {{Alcohol use disorder; Medical records; Mental health; Opioid use disorder; Substance use disorder; Suicide}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Drug and Alcohol Dependence}},
  title        = {{Substance use issues preceding suicide : A Swedish nationwide record review}},
  url          = {{http://dx.doi.org/10.1016/j.drugalcdep.2025.112736}},
  doi          = {{10.1016/j.drugalcdep.2025.112736}},
  volume       = {{274}},
  year         = {{2025}},
}