title: Licit and illicit substance use among people who inject drugs and the association with subsequent suicidal attempt.
abstract: OBJECTIVE
  To estimate associations between recent licit and illicit substance use and subsequent suicide attempt among people who inject drugs (PWID).
  
  
  METHODS
  Secondary analysis of longitudinal data from a prospective cohort study of PWID followed bi-annually between 2004 and 2011.
  
  
  METHODS
  Montréal, Canada.
  
  
  METHODS
  Seven hundred and ninety-seven PWID who reported injection drug use in the previous 6 months, contributing to a total of 4460 study visits. The median number of visits per participant was five (interquartile range: 3-8).
  
  
  METHODS
  An interviewer-administered questionnaire eliciting information on socio-demographic factors, detailed information on substance use patterns and related behaviours, mental health markers and suicide attempt. The primary exposure variables examined were past-month use of alcohol [heavy (≥ 60 drinks); moderate (one to 59 drinks); none], sedative-hypnotics, cannabis, cocaine, amphetamine and opioids [regular (≥ 4 days); occasional (1-3 days); none]. The outcome was a binary measure of suicide attempt assessed in reference to the previous 6 months.
  
  
  RESULTS
  In multivariate analyses, a positive association was found among licit substances between heavy alcohol consumption [adjusted odds ratio (AOR) = 2.05; 95% confidence interval (CI) = 1.12-3.75], regular use of sedative-hypnotics (AOR = 1.89; 95% CI = 1.21-2.95) and subsequent attempted suicide. Among illicit substances, occasional use of cannabis (AOR = 1.84; 95% CI = 1.09-3.13) had a positive association with subsequent suicide attempt. No statistically significant association was found for the remaining substances.
  
  
  CONCLUSIONS
  Among people who inject drugs, use of alcohol, sedative-hypnotics and cannabis, but not cocaine, amphetamine or opioids, appears to be associated with an increased likelihood of later attempted suicide.
authors.affiliation: Research Center, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Canada.|Department of Epidemiology, School of Public Health, Université de Montréal, Montréal, Canada.
authors.forename: Andreea Adelina
authors.initials: AA
authors.lastname: Artenie
authors.affiliation: Research Center, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Canada.|Department of Family and Emergency Medicine, Faculty of Medicine, Université de Montréal, Montréal, Canada.
authors.forename: Julie
authors.initials: J
authors.lastname: Bruneau
authors.affiliation: Addiction Research and Study Program, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Canada.|Institut National de Santé Publique du Québec, Montréal, Canada.
authors.forename: Élise
authors.initials: É
authors.lastname: Roy
authors.affiliation: Research Center, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Canada.
authors.forename: Geng
authors.initials: G
authors.lastname: Zang
authors.affiliation: Research Center, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Canada.|Department of Psychiatry, Faculty of Medicine, Université de Montréal, Montréal, Canada.
authors.forename: François
authors.initials: F
authors.lastname: Lespérance
authors.affiliation: Department of Psychiatry, Faculty of Medicine, McGill University, Montréal, Canada.
authors.forename: Johanne
authors.initials: J
authors.lastname: Renaud
authors.affiliation: Department of Psychoeducation, Université du Québec à Trois-Rivières, Trois-Rivières, Canada.
authors.forename: Joël
authors.initials: J
authors.lastname: Tremblay
authors.affiliation: Research Center, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Canada.|Department of Psychiatry, Faculty of Medicine, Université de Montréal, Montréal, Canada.
authors.forename: Didier
authors.initials: D
authors.lastname: Jutras-Aswad
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D000437:Alcoholism / Q000453:epidemiology; D019969:Amphetamine-Related Disorders / Q000453:epidemiology; D019970:Cocaine-Related Disorders / Q000453:epidemiology; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives; D013287:Illicit Drugs; D008297:Male; D008385:Marijuana Smoking / Q000453:epidemiology*; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D009293:Opioid-Related Disorders / Q000453:epidemiology; D011792:Quebec / Q000453:epidemiology; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D013406:Suicide, Attempted / Q000706:statistics & numerical data*
chemical_list: D006993:Hypnotics and Sedatives; D013287:Illicit Drugs
keywords: Alcohol; amphetamine; cannabis; cocaine; drug use; opioids; sedative; suicide