The NVDRS data on suicide (Fowler et al., 2018), examined in the following section, provides insight into the key circumstances preceding and surrounding death by suicide, including demographics, precipitants to suicide, methodology, and Demographic findings among suicide decedents According to the NVDRS, in 2014, approximately 59,000 people died in the United States as a result of violence-related injuries. This report summarizes data from CDC’s NVDRS regarding violent deaths from 18 U.S. states in 2014. Results are reported by sex, age group, race/ethnicity, marital status, location of injury, method of injury, circumstances of injury, and other selected characteristics. NVDRS collates documents for each death and links deaths that are related (e.g., multiple homicides, a homicide followed by a suicide or multiple suicides) into a single incident. Suicide is presently the 10th-leading cause of death overall in the United States and disproportionately affects young and middle-aged populations. It was among the top-two leading causes of death for persons ages 10 to 34 and among the top four for persons ages 35 to 54 years. Non-Hispanic American Indian/Alaska Native and non-Hispanic white males were disproportionally affected by suicide (Fowler et al., 2018), with American Indian/Alaskan Natives having the highest rate of any ethnic group in the US, with rates increasing since 2003 (Leavitt, Ertl, Sheats, Petrosky, et al., 2018). Suicides occurred at higher rates among men versus women in the NVDRS, a finding that cuts across many studies (Siegel & Rothman, 2016). With regard to ethnicity/race, suicide is more frequent among Caucasians and Non-Hispanic American Indians/Alaska Natives. Suicide is also elevated by age group, with people between ages of 45 and 64 having the highest rates, although the over-65 age group is gaining and has become the highest group by some measures. Suicides were preceded primarily by a mental health, intimate partner, substance abuse, or physical health problem or a crisis during the previous or upcoming two weeks. Homicide rates were higher among males and persons aged <1 year and 15 to 44 years; rates were highest among non- Suicide method and location of injury Fowler et al. (2018) identified that firearms were the most frequently-used method of suicide (51.1%), followed by hanging/ strangulation/suffocation (27%) and poisoning (15.2%), each with rates of 7.1, 3.8, and 2.1 per 100,000 population, respectively. Among males, the same pattern holds with the most common method used being a firearm (56.6%), followed by hanging/ Toxicology and substance use among suicide decedents Substance use has been identified as a key issue in the NVDRS data (Fowler et al., 2018). Alcohol tests were conducted for 53.1% of suicide decedents. Tests were also conducted for amphetamines (31.1%), antidepressants (26%), benzodiazepines (33.7%), cocaine (32.6%), marijuana (29%) and opiates (36.2%). Among those with positive alcohol results (40.2%), 69.4% had a blood alcohol concentration (BAC) =0.08 g/dL. Tests identified opiates (including heroin and prescription pain medications) in 30% of decedents tested for these substances; cocaine and marijuana were identified in 5.7% and 21% of decedents tested, respectively. Of those tested for antidepressants, 40.8% percent had positive results at the time of their death, and 32.6% of those tested for benzodiazepines had positive results. Poisoning and substance abuse figure prominently in violent deaths. As identified by Fowler et al. (2018), NVDRS reported that poisoning was the third-most common means of suicide, as well as the top suicide method for women. In addition, poisoning deaths constitute the overwhelming majority of deaths of undetermined intent captured by NVDRS (73.8%). Approximately 75% of all decedents who received toxicology testing had one or more substances detected, and 42.8% had
toxicology. Data specifically refer to those whose deaths were ruled as suicide in the NVDRS, and those who have died by suicide are typically referred to as suicide decedents.
Hispanic Black and American Indian/Alaskan Native males according to the CDC and NVDRS findings. Homicides primarily were precipitated by arguments and interpersonal conflicts, occurrence in conjunction with another crime, or related to intimate partner violence (particularly for females). When the relationship between a homicide victim and a suspected perpetrator was known, it was most often either an acquaintance/friend or an intimate partner. Legal intervention death rates were highest among males and persons ages 20 to 44; rates were highest among non-Hispanic Black males and Hispanic males. Precipitating factors for the majority of legal intervention deaths were alleged criminal activity in progress, the victim reportedly using a weapon in the incident, a mental health or substance abuse problem, an argument or conflict, or a recent crisis. Deaths of undetermined intent occurred more frequently among males, particularly non-Hispanic Black and American Indian/Alaskan Native males, and persons ages 30 to 54. Substance abuse, mental health problems, physical health problems, and a recent crisis were the most common circumstances preceding deaths of undetermined intent. Unintentional firearm deaths were more frequent among males, non-Hispanic whites, and persons ages 10 to 24 years; these deaths most often occurred while the shooter was playing with a firearm and were most often precipitated by a person unintentionally pulling the trigger or mistakenly thinking the firearm was unloaded. These results indicate that violent deaths resulting from self-inflicted or interpersonal violence disproportionately affected persons younger than 56, males, and certain minority populations. The primary precipitating factors across homicides and suicides were intimate partner problems, interpersonal conflicts, mental health and substance abuse problems, and recent crises. strangulation/suffocation (27%). Among females, however, poisoning was the most common method used (33.4%), followed by a firearm (32.6%). The most common place of suicide was a house or apartment (75.3%), followed by a natural area (4.6%), a motor vehicle (4.4%), a hotel/motel (2.4%), and a street/highway (2.3%). two or more (range: two to 12). These percentages were even higher for decedents with a history of drug or alcohol abuse (i.e., substance abuse); of those decedents, 87.8% had one or more substances detected in their system at the time of death, and 53.3% had more than one. The percentage of suicide decedents with prior substance abuse problems (other than alcohol) who died by poisoning was twice as high as the percentage of suicide decedents without prior substance abuse problems who died by poisoning (26% versus 13%, respectively). The most common substance types detected in suicide decedents with a history of substance abuse were alcohol (51.1%), over-the-counter or otherwise unclassified drugs (31.7%), benzodiazepines (23.3%), opioids (23.2%), antidepressants (20%), and marijuana (13.6%). Opioids and over-the-counter drugs most frequently caused death in isolation; opioids in combination with benzodiazepines or antidepressants were some of the more commonly occurring combinations of substances that caused death. Unintentional opioid overdose has been recognized as an epidemic and these findings mirror concerns regarding the overdose potential of opioids. In response to these concerns, CDC recently issued
EliteLearning.com/Psychology
Book Code: PYCA1423
Page 50
Powered by FlippingBook