Suicidal intent in fatal drug overdoses

致命药物过量的自杀意图

• 批准号: 10726968
• 负责人: Alexander Lundberg
• 金额: $ 20万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10726968
• 关键词: Acceleration; Accidents; Autopsy; COVID-19 mortality; COVID-19 pandemic; Catalogs; Cause of Death; Cessation of life; Characteristics; Classification; Communities; Coroner; Coroners and Medical Examiners; County; Data; Data Science; Data Sources; Death Certificates; Demography; Development; Drug abuse; Economic Conditions; Economics; Emergency Medicine; Epidemiology; Fatality rate; Feeling suicidal; Forensic Medicine; Fright; Growth; Homicide; Illinois; Incidence; Information Systems; Instruction; Intervention; Investigation; Kentucky; Law Enforcement; Length; Linguistics; Litigation; Mediating; Medical Examiners; Mental Health; Mental Health Services; Methods; Michigan; Modeling; Overdose; Persons; Pharmaceutical Preparations; Philosophy; Physicians; Poisoning; Police; Policies; Population; Prevention; Prevention Research; Prevention strategy; Procedures; Public Health; Reporting; Reproducibility; Research; Research Personnel; Resource Allocation; Role; Sampling; Secure; Sociology; Source; Statistical Methods; Suicide; Suicide prevention; System; Technology; Text; Time; Toxicology; Training; United States; Violence; data sharing; experience; health care availability; innovation; insight; mortality; novel; overdose death; socioeconomics; structured data; substance use; suicidal; suicidal morbidity; suicide model; suicide mortality; suicide rate; suicide victim; trend; Acceleration; Accidents; Autopsy; COVID-19 mortality; COVID-19 pandemic; Catalogs; Cause of Death; Cessation of life; Characteristics; Classification; Communities; Coroner; Coroners and Medical Examiners; County; Data; Data Science; Data Sources; Death Certificates; Demography; Development; Drug abuse; Economic Conditions; Economics; Emergency Medicine; Epidemiology; Fatality rate; Feeling suicidal; Forensic Medicine; Fright; Growth; Homicide; Illinois; Incidence; Information Systems; Instruction; Intervention; Investigation; Kentucky; Law Enforcement; Length; Linguistics; Litigation; Mediating; Medical Examiners; Mental Health; Mental Health Services; Methods; Michigan; Modeling; Overdose; Persons; Pharmaceutical Preparations; Philosophy; Physicians; Poisoning; Police; Policies; Population; Prevention; Prevention Research; Prevention strategy; Procedures; Public Health; Reporting; Reproducibility; Research; Research Personnel; Resource Allocation; Role; Sampling; Secure; Sociology; Source; Statistical Methods; Suicide; Suicide prevention; System; Technology; Text; Time; Toxicology; Training; United States; Violence; data sharing; experience; health care availability; innovation; insight; mortality; novel; overdose death; socioeconomics; structured data; substance use; suicidal; suicidal morbidity; suicide model; suicide mortality; suicide rate; suicide victim; trend

Project Summary The national suicide rate has grown by 30% over the last twenty years, and nearly 46,000 people died by suicide in 2020. The rate of drug overdose death has grown even more dramatically over the same period. Nearly 108,000 people died by drug overdose in 2021, an all-time high. Substance use and suicidal ideation are strongly correlated. This overlap makes intent difficult for death investigators to classify in fatal drug overdoses. Consequently, many overdose deaths ruled unintentional or “undetermined” may in fact be suicide victims. This project will leverage data from death certificate, toxicology, police, and coroner/medical examiner reports to investigate how medicolegal death investigators classify intent within fatal drug overdoses. The data sample contains three states in a region with high rates of drug abuse and overdose death. With a mixed methods approach of quantitative and linguistic analysis, the project will first identify which factors are most predictive of intent classification. Potential factors include characteristics of decedents, death investigation systems, and the socioeconomic conditions of communities. The principal data sources are the National Violent Death Reporting System (NVDRS) and the State Unintentional Drug Overdose Reporting System (SUDORS). Both sources contain decedent-level information. Whereas NVDRS contains intentional deaths by drug poisoning (suicide), SUDORS contains unintentional (accidental) and “undetermined” deaths. The combination of these sources will provide novel insight on suicidal intent among fatal drug overdoses. The project will also develop a statistical adjustment to estimate underreported suicide deaths. This adjustment will build from a model of suicide deaths by drug poisoning (in NVDRS) to estimate rates of underreported suicide deaths in the unintentional and “undetermined” fatal overdose deaths (in SUDORS). The project will therefore help identify populations in critical need of mental healthcare access and treatment. Furthermore, unintentional drug overdose deaths and suicide deaths require a different set of prevention strategies and policies. Accurate mortality surveillance systems are therefore central to either prevention effort. The analyses in this project will inform points of intervention for death investigator instruction on the important classification of intent within fatal drug overdoses.

项目摘要 在过去的二十年中，全国自杀率增长了30％，近46,000人死亡 自杀于2020年。在同一时期，药物过量死亡的率更加明显。 在2021年，近108,000人因药物过量而死亡，这是历史最高的。药物使用和自杀想法 密切相关。这种重叠使死亡调查人员的意图很难分类为致命药物 过量服用。因此，许多过量死亡裁定无意或“不确定”可能是自杀 出奇。该项目将利用死亡证明，毒理学，警察和验尸官/医学检查员的数据 报告调查中介死亡研究者如何在致命药物过量中对意图进行分类。数据 样本包含高药物滥用率和过量死亡率的地区的三个州。混合 定量和语言分析的方法方法，该项目将首先确定哪些因素是最大的 预测意图分类。潜在因素包括死者的特征，死亡调查 系统和社区的社会经济条件。主要数据来源是国家 暴力死亡报告系统（NVDRS）和州无意的药物过量报告系统 （Sudors）。两个来源都包含决定级别的信息。而NVDR则包含故意死亡 毒品中毒（自杀），Sudors包含无意（意外）和“未定”死亡。 这些来源的结合将为致命药物过量的自杀意图提供新的见解。这 项目还将制定统计调整以估计自杀死亡人数不足。这种调整将 从药物中毒（在NVDR中）的自杀死亡模型建立到估计自杀率不足的发生率 无意识和“不确定”致命的过量死亡（在Sudors中）死亡。因此，该项目将 帮助确定迫切需要心理保健访问和治疗的人群。此外，无意 药物过量死亡和自杀死亡需要不同的预防策略和政策。准确的 因此，死亡率监视系统对于预防工作都是至关重要的。该项目的分析将 为死亡研究者的干预点提供有关致命意图的重要分类的指导 药物过量。