title: Substance misuse in life and death in a 2-year cohort of suicides.
abstract: BACKGROUND
  Although substance misuse is a key risk factor in suicide, relatively little is known about the relationship between lifetime misuse and misuse at the time of suicide.
  
  
  OBJECTIVE
  To examine the relationship between substance misuse and subsequent suicide.
  
  
  METHODS
  Linkage of coroners' reports to primary care records for 403 suicides occurring over 2 years.
  
  
  RESULTS
  With alcohol misuse, 67% of the cohort had previously sought help for alcohol problems and 39% were intoxicated at the time of suicide. Regarding misuse of other substances, 54% of the cohort was tested. Almost one in four (38%) tested positive, defined as an excess of drugs over the prescribed therapeutic dosage and/or detection of illicit substances. Those tested were more likely to be young and have a history of drug misuse.
  
  
  CONCLUSIONS
  A deeper understanding of the relationship between substance misuse and suicide could contribute to prevention initiatives. Furthermore, standardised toxicology screening processes would avoid diminishing the importance of psychosocial factors involved in suicide as a 'cause of death'.
authors.affiliation: Karen Galway, PhD, School of Nursing and Midwifery, Queen's University Belfast, Belfast; Diana Gossrau-Breen, PhD, Public Health Agency for Northern Ireland, UK; Sharon Mallon, PhD, Faculty of Health & Social Care, Open University, UK; Lynette Hughes, PhD, Northern Ireland Association for Mental Health, UK; Michael Rosato, PhD, Janeet Rondon-Sulbaran, MSc, Gerard Leavey, PhD, Bamford Centre for Mental Health and Wellbeing, Ulster University, UK k.galway@qub.ac.uk.
authors.forename: Karen
authors.initials: K
authors.lastname: Galway
authors.affiliation: Karen Galway, PhD, School of Nursing and Midwifery, Queen's University Belfast, Belfast; Diana Gossrau-Breen, PhD, Public Health Agency for Northern Ireland, UK; Sharon Mallon, PhD, Faculty of Health & Social Care, Open University, UK; Lynette Hughes, PhD, Northern Ireland Association for Mental Health, UK; Michael Rosato, PhD, Janeet Rondon-Sulbaran, MSc, Gerard Leavey, PhD, Bamford Centre for Mental Health and Wellbeing, Ulster University, UK.
authors.forename: Diana
authors.initials: D
authors.lastname: Gossrau-Breen
authors.affiliation: Karen Galway, PhD, School of Nursing and Midwifery, Queen's University Belfast, Belfast; Diana Gossrau-Breen, PhD, Public Health Agency for Northern Ireland, UK; Sharon Mallon, PhD, Faculty of Health & Social Care, Open University, UK; Lynette Hughes, PhD, Northern Ireland Association for Mental Health, UK; Michael Rosato, PhD, Janeet Rondon-Sulbaran, MSc, Gerard Leavey, PhD, Bamford Centre for Mental Health and Wellbeing, Ulster University, UK.
authors.forename: Sharon
authors.initials: S
authors.lastname: Mallon
authors.affiliation: Karen Galway, PhD, School of Nursing and Midwifery, Queen's University Belfast, Belfast; Diana Gossrau-Breen, PhD, Public Health Agency for Northern Ireland, UK; Sharon Mallon, PhD, Faculty of Health & Social Care, Open University, UK; Lynette Hughes, PhD, Northern Ireland Association for Mental Health, UK; Michael Rosato, PhD, Janeet Rondon-Sulbaran, MSc, Gerard Leavey, PhD, Bamford Centre for Mental Health and Wellbeing, Ulster University, UK.
authors.forename: Lynette
authors.initials: L
authors.lastname: Hughes
authors.affiliation: Karen Galway, PhD, School of Nursing and Midwifery, Queen's University Belfast, Belfast; Diana Gossrau-Breen, PhD, Public Health Agency for Northern Ireland, UK; Sharon Mallon, PhD, Faculty of Health & Social Care, Open University, UK; Lynette Hughes, PhD, Northern Ireland Association for Mental Health, UK; Michael Rosato, PhD, Janeet Rondon-Sulbaran, MSc, Gerard Leavey, PhD, Bamford Centre for Mental Health and Wellbeing, Ulster University, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Rosato
authors.affiliation: Karen Galway, PhD, School of Nursing and Midwifery, Queen's University Belfast, Belfast; Diana Gossrau-Breen, PhD, Public Health Agency for Northern Ireland, UK; Sharon Mallon, PhD, Faculty of Health & Social Care, Open University, UK; Lynette Hughes, PhD, Northern Ireland Association for Mental Health, UK; Michael Rosato, PhD, Janeet Rondon-Sulbaran, MSc, Gerard Leavey, PhD, Bamford Centre for Mental Health and Wellbeing, Ulster University, UK.
authors.forename: Janeet
authors.initials: J
authors.lastname: Rondon-Sulbaran
authors.affiliation: Karen Galway, PhD, School of Nursing and Midwifery, Queen's University Belfast, Belfast; Diana Gossrau-Breen, PhD, Public Health Agency for Northern Ireland, UK; Sharon Mallon, PhD, Faculty of Health & Social Care, Open University, UK; Lynette Hughes, PhD, Northern Ireland Association for Mental Health, UK; Michael Rosato, PhD, Janeet Rondon-Sulbaran, MSc, Gerard Leavey, PhD, Bamford Centre for Mental Health and Wellbeing, Ulster University, UK.
authors.forename: Gerard
authors.initials: G
authors.lastname: Leavey
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D015331:Cohort Studies; D005260:Female; D000066505:Help-Seeking Behavior; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009660:Northern Ireland; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000401:mortality*; D013405:Suicide / Q000706:statistics & numerical data*; D055815:Young Adult; D000092864:Suicide Prevention