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From Substance Use Disorders in Life to Autopsy Findings : A Combined Case-Record and Medico-Legal Study

Brådvik, Louise LU ; Löwenhielm, Peter LU ; Frank, Arne LU and Berglund, Mats LU (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
organization
publishing date
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
Multidisciplinary Digital Publishing Institute
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
2020-01-13 01:34:12
@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},
  language     = {eng},
  month        = {03},
  number       = {5},
  publisher    = {Multidisciplinary Digital Publishing Institute},
  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},
}