title: Confronting death from drug self-intoxication (DDSI): prevention through a better definition.
abstract: Suicide and other self-directed violence deaths are likely grossly underestimated, reflecting inappropriate classification of many drug intoxication deaths as accidents or unintentional and heterogeneous ascertainment and coding practices across states. As the tide of prescription and illicit drug-poisoning deaths is rising, public health and research needs would be better satisfied by considering most of these deaths a result of self-intoxication. Epidemiologists and prevention scientists could design better intervention strategies by focusing on premorbid behavior. We propose incorporating deaths from drug self-intoxication and investigations of all poisoning deaths into the National Violent Death Reporting System, which contains misclassified homicides and undetermined intent deaths, to facilitate efforts to comprehend and reverse the surging rate of drug intoxication fatalities.
authors.affiliation: Ian R. H. Rockett is with the Department of Epidemiology, West Virginia University, Morgantown. Gordon S. Smith is with the Department of Epidemiology and Public Health, University of Maryland, Baltimore. Eric D. Caine is with the Injury Control Research Center for Suicide Prevention, University of Rochester Medical Center, Rochester, NY. Nestor D. Kapusta is with the Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria. Randy L. Hanzlick is with the Fulton County Medical Examiner's Center, Emory University, Atlanta, GA. G. Luke Larkin is with the Department of Surgery, University of Auckland, Auckland, New Zealand. Charles P. E. Naylor is with the Forensic and Scientific Services, Department of Health, Brisbane, Queensland, Australia. Kurt B. Nolte is with the Office of the Medical Investigator, University of New Mexico School of Medicine, Albuquerque. Ted R. Miller is with the Pacific Institute for Research and Evaluation, Calverton, MD. Sandra L. Putnam is with Social Solutions International, Silver Spring, MD. Diego De Leo is with the Australian Institute for Suicide Research and Prevention, Griffith University, Brisbane, Queensland, Australia. John Kleinig is with the Department of Criminal Justice, City University of New York. Steven Stack is with the Department of Criminal Justice, Wayne State University, Detroit, MI. Knox H. Todd is with the Department of Emergency Medicine, University of Texas MD Anderson Cancer Center, Houston. David W. Fraser is with the Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia.
authors.forename: Ian R H
authors.initials: IR
authors.lastname: Rockett
authors.forename: Gordon S
authors.initials: GS
authors.lastname: Smith
authors.forename: Eric D
authors.initials: ED
authors.lastname: Caine
authors.forename: Nestor D
authors.initials: ND
authors.lastname: Kapusta
authors.forename: Randy L
authors.initials: RL
authors.lastname: Hanzlick
authors.forename: G Luke
authors.initials: GL
authors.lastname: Larkin
authors.forename: Charles P E
authors.initials: CP
authors.lastname: Naylor
authors.forename: Kurt B
authors.initials: KB
authors.lastname: Nolte
authors.forename: Ted R
authors.initials: TR
authors.lastname: Miller
authors.forename: Sandra L
authors.initials: SL
authors.lastname: Putnam
authors.forename: Diego
authors.initials: D
authors.lastname: De Leo
authors.forename: John
authors.initials: J
authors.lastname: Kleinig
authors.forename: Steven
authors.initials: S
authors.lastname: Stack
authors.forename: Knox H
authors.initials: KH
authors.lastname: Todd
authors.forename: David W
authors.initials: DW
authors.lastname: Fraser
mesh_terms: D002423:Cause of Death; D062787:Drug Overdose / Q000401:mortality* / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D011041:Poisoning / Q000401:mortality* / Q000517:prevention & control*; D011159:Population Surveillance; D013405:Suicide / Q000706:statistics & numerical data; D009626:Terminology as Topic; D014481:United States / Q000453:epidemiology; D000092864:Suicide Prevention