Médicaments en vente libre et autres substances utilisées lors de tentatives de suicide par des patients s'étant présentés aux services des urgences de Montréal

Alexandre Mikhail, Omaid Tanoli, Gilles Légaré, Pierre-André Dubé, Youssef Habel, Alain Lesage, Nancy Low, Suzanne Lamarre, Santokh Singh, Elham Rahme

L'équipe de recherche du Dre Elham Rhame de l'Université McGill a publié en septembre 2018 les résultats de leur étude intitulée Over-the-Counter Drugs and Other Substances Used in Attempted Suicide Presented to Emergency Departments in Montreal, Canada dans le journal Crisis - The Journal of Crisis Intervention and Suicide Prevention. Monsieur Pierre-André Dubé, pharmacien-toxicologue à l'Institut national de santé publique du Québec, a collaboré à cette recherche.

Background: Over-the-counter (OTC) analgesics are frequently used in suicide attempts. Accessibility, toxicity, and unsupervised acquisition of large amounts may be facilitators. 

Aims: To identify patient characteristics associated with OTC drug use as a suicide attempt method among adults. Method: A cross-sectional study was conducted using chart review of all individuals who presented to the emergency department (ED) of two adult general hospitals following a suicide attempt during 2009–2010 in Montreal, Canada. 

Results: Among the 369 suicide attempters identified, 181 used overdosing, 47% of whom used OTC drugs. In logistic regression, women and those with medical comorbidity were more likely to use overdosing, while those with substance use disorders were less likely to do so. Among those who overdosed, women were more likely to use OTC drugs, while those who were Caucasian, had children, comorbidities, diagnosed with substance use disorders, and made attempts in the Fall were less likely to do so. Substances most frequently used were: acetaminophen among OTC drugs (30%); antidepressants (37%), anxiolytics (30%), opioids (10%), and anticonvulsants (9%) among prescription drugs; and cocaine (10%) among recreational drugs. 

Limitations: Reasons for the suicide method choice were not available. 

Conclusion: OTC drugs, in particular acetaminophen, are frequently used in suicide attempts. Accessibility to these drugs may be an important contributor.

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Crisis journal

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