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In previous work, we demonstrated that heavy alcohol use (defined as postmortem blood alcohol content [BAC] ≥.08 g/dL) prior to suicide varied by race-ethnicity (1), ranging from 13% among Asian/Pacific Islander (Asian/PI) to 36% of American Indian/Alaska Native (AI/AN) decedents. We also showed that persons who later died by suicide were more likely to drink and to do so heavily, compared with a living sample (2).
Using data from the 2005–2011 National Violent Death Reporting System (N=52,276) and the 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions (N=43,093), we examined heavy alcohol use. We stratified by gender and adjusted for age and alcohol dependence. Heavy use was defined for suicide decedents as a BAC ≥.08 g/dL and for living comparison participants as drinking up to 48 hours prior to the interview and typically consuming five or more or four or more drinks per drinking day for men and women, respectively.
Figure 1 shows that all decedents were much more likely than comparison participants to have used alcohol heavily. Especially noteworthy are elevated odds ratios for Asian/PIs and Latinas. Risk of suicide due to heavy alcohol use was substantial across all racial-ethnic groups and especially for Latinas. Policies minimizing harmful alcohol use are essential for suicide prevention.
FIGURE 1. Likelihood of heavy alcohol use prior to suicide, by racial-ethnic groupa
aPercentages are rates of heavy use before suicide or before the interview (nonsuicide). ORs (bars represent 95% CIs) are from regression models adjusted for age and alcohol dependence that compared the likelihood of heavy use among suicide decedents versus the nonsuicide sample.

References

1.
Caetano R, Kaplan MS, Huguet N, et al: Acute alcohol intoxication and suicide among United States ethnic/racial groups: findings from the national violent death reporting system. Alcoholism, Clinical and Experimental Research 37:839–846, 2013
2.
Kaplan MS, Huguet N, McFarland BH, et al: Use of alcohol before suicide in the United States. Annals of Epidemiology 24:588–592, 2014

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Cover: Bowl, by Louis Comfort Tiffany, circa 1908. Favrile glass. Gift of Louis Comfort Tiffany Foundation, 1951 (51.121.13). Metropolitan Museum of Art, New York City. Image copyright © The Metropolitan Museum of Art. Image source: Art Resource, New York City.

Psychiatric Services
Pages: 258
PubMed: 26725300

History

Published online: 4 January 2016
Published in print: March 01, 2016

Authors

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Mark S. Kaplan
Dr.P.H.
Dr. Kaplan is with the Luskin School of Public Affairs, University of California, Los Angeles (e-mail: [email protected]). Dr. Huguet and Dr. McFarland are with the Oregon Health and Science University, Portland. Dr. Caetano is with the Pacific Institute for Research and Evaluation, Oakland, California. Dr. Conner is with the VISN 2 Center of Excellence for Suicide Prevention, U.S. Department of Veterans Affairs, Canandaigua, New York, and the University of Rochester Medical Center, Rochester, New York. Dr. Nolte is with the University of New Mexico, Albuquerque. Dr. Giesbrecht is with the Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Amy M. Kilbourne, Ph.D., M.P.H., and Tami L. Mark, Ph.D., are editors of this column.
Nathalie Huguet, Ph.D.
Dr. Kaplan is with the Luskin School of Public Affairs, University of California, Los Angeles (e-mail: [email protected]). Dr. Huguet and Dr. McFarland are with the Oregon Health and Science University, Portland. Dr. Caetano is with the Pacific Institute for Research and Evaluation, Oakland, California. Dr. Conner is with the VISN 2 Center of Excellence for Suicide Prevention, U.S. Department of Veterans Affairs, Canandaigua, New York, and the University of Rochester Medical Center, Rochester, New York. Dr. Nolte is with the University of New Mexico, Albuquerque. Dr. Giesbrecht is with the Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Amy M. Kilbourne, Ph.D., M.P.H., and Tami L. Mark, Ph.D., are editors of this column.
Bentson H. McFarland, M.D., Ph.D.
Dr. Kaplan is with the Luskin School of Public Affairs, University of California, Los Angeles (e-mail: [email protected]). Dr. Huguet and Dr. McFarland are with the Oregon Health and Science University, Portland. Dr. Caetano is with the Pacific Institute for Research and Evaluation, Oakland, California. Dr. Conner is with the VISN 2 Center of Excellence for Suicide Prevention, U.S. Department of Veterans Affairs, Canandaigua, New York, and the University of Rochester Medical Center, Rochester, New York. Dr. Nolte is with the University of New Mexico, Albuquerque. Dr. Giesbrecht is with the Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Amy M. Kilbourne, Ph.D., M.P.H., and Tami L. Mark, Ph.D., are editors of this column.
Raul Caetano, M.D., Ph.D.
Dr. Kaplan is with the Luskin School of Public Affairs, University of California, Los Angeles (e-mail: [email protected]). Dr. Huguet and Dr. McFarland are with the Oregon Health and Science University, Portland. Dr. Caetano is with the Pacific Institute for Research and Evaluation, Oakland, California. Dr. Conner is with the VISN 2 Center of Excellence for Suicide Prevention, U.S. Department of Veterans Affairs, Canandaigua, New York, and the University of Rochester Medical Center, Rochester, New York. Dr. Nolte is with the University of New Mexico, Albuquerque. Dr. Giesbrecht is with the Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Amy M. Kilbourne, Ph.D., M.P.H., and Tami L. Mark, Ph.D., are editors of this column.
Kenneth R. Conner, Psy.D., M.P.H.
Dr. Kaplan is with the Luskin School of Public Affairs, University of California, Los Angeles (e-mail: [email protected]). Dr. Huguet and Dr. McFarland are with the Oregon Health and Science University, Portland. Dr. Caetano is with the Pacific Institute for Research and Evaluation, Oakland, California. Dr. Conner is with the VISN 2 Center of Excellence for Suicide Prevention, U.S. Department of Veterans Affairs, Canandaigua, New York, and the University of Rochester Medical Center, Rochester, New York. Dr. Nolte is with the University of New Mexico, Albuquerque. Dr. Giesbrecht is with the Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Amy M. Kilbourne, Ph.D., M.P.H., and Tami L. Mark, Ph.D., are editors of this column.
Kurt B. Nolte, M.D.
Dr. Kaplan is with the Luskin School of Public Affairs, University of California, Los Angeles (e-mail: [email protected]). Dr. Huguet and Dr. McFarland are with the Oregon Health and Science University, Portland. Dr. Caetano is with the Pacific Institute for Research and Evaluation, Oakland, California. Dr. Conner is with the VISN 2 Center of Excellence for Suicide Prevention, U.S. Department of Veterans Affairs, Canandaigua, New York, and the University of Rochester Medical Center, Rochester, New York. Dr. Nolte is with the University of New Mexico, Albuquerque. Dr. Giesbrecht is with the Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Amy M. Kilbourne, Ph.D., M.P.H., and Tami L. Mark, Ph.D., are editors of this column.
Norman Giesbrecht, Ph.D.
Dr. Kaplan is with the Luskin School of Public Affairs, University of California, Los Angeles (e-mail: [email protected]). Dr. Huguet and Dr. McFarland are with the Oregon Health and Science University, Portland. Dr. Caetano is with the Pacific Institute for Research and Evaluation, Oakland, California. Dr. Conner is with the VISN 2 Center of Excellence for Suicide Prevention, U.S. Department of Veterans Affairs, Canandaigua, New York, and the University of Rochester Medical Center, Rochester, New York. Dr. Nolte is with the University of New Mexico, Albuquerque. Dr. Giesbrecht is with the Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Amy M. Kilbourne, Ph.D., M.P.H., and Tami L. Mark, Ph.D., are editors of this column.

Funding Information

This research was supported by the National Institute on Alcohol Abuse and Alcoholism (grant R01-AA020063).The authors report no financial relationships with commercial interests.

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