title: Drug suicide: a sex-equal cause of death in 16 European countries.
abstract: BACKGROUND
  There is a lack of international research on suicide by drug overdose as a preventable suicide method. Sex- and age-specific rates of suicide by drug self-poisoning (ICD-10, X60-64) and the distribution of drug types used in 16 European countries were studied, and compared with other self-poisoning methods (X65-69) and intentional self-injury (X70-84).
  
  
  METHODS
  Data for 2000-04/05 were collected from national statistical offices. Age-adjusted suicide rates, and age and sex distributions, were calculated.
  
  
  RESULTS
  No pronounced sex differences in drug self-poisoning rates were found, either in the aggregate data (males 1.6 and females 1.5 per 100,000) or within individual countries. Among the 16 countries, the range (from some 0.3 in Portugal to 5.0 in Finland) was wide. 'Other and unspecified drugs' (X64) were recorded most frequently, with a range of 0.2-1.9, and accounted for more than 70% of deaths by drug overdose in France, Luxembourg, Portugal and Spain. Psychotropic drugs (X61) ranked second. The X63 category ('other drugs acting on the autonomic nervous system') was least frequently used. Finland showed low X64 and high X61 figures, Scotland had high levels of X62 ('narcotics and hallucinogens, not elsewhere classified') for both sexes, while England exceeded other countries in category X60. Risk was highest among the middle-aged everywhere except in Switzerland, where the elderly were most at risk.
  
  
  CONCLUSIONS
  Suicide by drug overdose is preventable. Intentional self-poisoning with drugs kills as many males as females. The considerable differences in patterns of self-poisoning found in the various European countries are relevant to national efforts to improve diagnostics of suicide and appropriate specific prevention. The fact that vast majority of drug-overdose suicides came under the category X64 refers to the need of more detailed ICD coding system for overdose suicides is needed to permit better design of suicide-prevention strategies at national level.
authors.affiliation: Estonian-Swedish Mental Health and Suicidology Institute; Estonian Centre of Behavioural and Health Sciences, Õie 39, Tallinn 11615, Estonia. airiv@online.ee
authors.forename: Airi
authors.initials: A
authors.lastname: Värnik
authors.forename: Merike
authors.initials: M
authors.lastname: Sisask
authors.forename: Peeter
authors.initials: P
authors.lastname: Värnik
authors.forename: Jing
authors.initials: J
authors.lastname: Wu
authors.forename: Kairi
authors.initials: K
authors.lastname: Kõlves
authors.forename: Ella
authors.initials: E
authors.lastname: Arensman
authors.forename: Margareth
authors.initials: M
authors.lastname: Maxwell
authors.forename: Thomas
authors.initials: T
authors.lastname: Reisch
authors.forename: Ricardo
authors.initials: R
authors.lastname: Gusmão
authors.forename: Chantal
authors.initials: C
authors.lastname: van Audenhove
authors.forename: Gert
authors.initials: G
authors.lastname: Scheerder
authors.forename: Christina M
authors.initials: CM
authors.lastname: van der Feltz-Cornelis
authors.forename: Claire
authors.initials: C
authors.lastname: Coffey
authors.forename: Maria
authors.initials: M
authors.lastname: Kopp
authors.forename: Andras
authors.initials: A
authors.lastname: Szekely
authors.forename: Saska
authors.initials: S
authors.lastname: Roskar
authors.forename: Ulrich
authors.initials: U
authors.lastname: Hegerl
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002423:Cause of Death / Q000639:trends*; D062787:Drug Overdose / Q000453:epidemiology / Q000401:mortality*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011041:Poisoning / Q000453:epidemiology*; D016728:Self-Injurious Behavior / Q000453:epidemiology / Q000401:mortality* / Q000517:prevention & control; D012737:Sex Factors; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology; D013405:Suicide / Q000706:statistics & numerical data*; D000092864:Suicide Prevention