Trends in suicide from drug overdose in the elderly in England and Wales, 1993-1999.
BACKGROUND
Drug overdose is a common method of suicide in the elderly. Hence, an understanding of current trends in epidemiology of these deaths is important when considering measures to decrease suicide rates.


METHODS
Analysis of the Office for National Statistics (ONS) database of deaths from overdose and poisoning. Suicide and undetermined deaths from drug overdose between 1993-1999 in the over 65 year olds were studied. Socio-demographic data from the four drug groups most commonly used in overdose were extracted, and age and sex specific mortality rates calculated. Enumeration districts were ranked into five quintiles based on their Carstairs scores, and death rates in each quintile for men and women calculated.


RESULTS
There were 1864 deaths from drug overdose during the study period. Suicide and undetermined death rates from drug overdose remained stable between 1993-1999. Drugs most commonly used in overdose were (in order) paracetamol (and related compounds), benzodiazepines, antidepressants, and opiates. Women comprised 62% of deaths. Death rates increased with age, with highest rates in men over 75 (37.7 deaths per million). Benzodiazepines showed the most marked increase with age. Co-proxamol comprised 32% of deaths from paracetamol compounds, and 95% of antidepressant deaths were due to tricyclic antidepressants. There was no association in women between Carstairs area deprivation and suicide rates; in men rates were highest in the most deprived areas.


CONCLUSIONS
Suicides in the over 65 year olds may be decreased by changes in prescription practice. Paracetamol, co-proxamol, tricyclic antidepressants and benzodiazepines should be prescribed with caution to the elderly with depression or at high risk of depression.
Shah
Rajen
R
Sutton Hospital, Sutton, Surrey, UK. heddon@heddon40.screaming.net
Uren
Zoë
Z
Baker
Allan
A
Majeed
Azeem
A
D000082:Acetaminophen / Q000506:poisoning; D017677:Age Distribution; D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000506:poisoning; D014151:Anti-Anxiety Agents / Q000506:poisoning; D000928:Antidepressive Agents / Q000506:poisoning; D001569:Benzodiazepines; D062787:Drug Overdose / Q000401:mortality*; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D009294:Narcotics / Q000506:poisoning; D011203:Poverty; D017678:Sex Distribution; D013405:Suicide / Q000639:trends*; D014852:Wales / Q000453:epidemiology; D000092864:Suicide Prevention
D018712:Analgesics, Non-Narcotic; D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D009294:Narcotics; D001569:Benzodiazepines; D000082:Acetaminophen