LETTER TO THE EDITOR
REVISTA DE LA FACULTAD DE MEDICINA HUMANA 2024 - Universidad Ricardo Palma10.25176/RFMH.v24i3.6474
DRUG DEPENDENCE AND SUICIDE, A GROWING PROBLEM
FARMACODEPENDENCIA Y SUICIDIO, UNA PROBLEMÁTICA CRECIENTE
Hector E. Leon
1,a
1 Instituto de Investigaciones en ciencias biomédicas, Universidad Ricardo Palma, Lima, Peru.
a Human Medicine Student.
Dear Editor,
Drug dependence is a complex medical and psychological condition associated with a variety of mental and physical health risks. However, one of the most alarming risks is the significant increase in suicidal behavior among those struggling with substance addiction (1). According to 2018 data, drug-dependent patients face up to six times the risk of suicide attempts compared to the general population. This dramatic increase in vulnerability is exacerbated by the presence of coexisting psychiatric disorders, social isolation, and easy access to lethal means (2). The intersection between drug dependence and suicide risk is a worrying reality that demands immediate attention.
Globally, suicide is the third leading cause of violent death among individuals aged 10 to 24 and accounts for approximately 1.5% of all deaths. Additionally, the United Nations Office on Drugs and Crime estimated that in 2020, 284 million people worldwide, aged 14 to 64, used at least one drug in the past 12 months, representing a 26% increase compared to 2010 (3, 4). Armoon et al. found that the main risk factors for suicidal behavior in drug-dependent patients are a history of sexual abuse, previous suicidal ideation, female gender, concomitant depression, and tobacco use (5). According to Stone et al., the suicide rate in the United States increased by 35% between 2000 and 2018. In the same study, it was observed that out of a sample of 20,446 people with suicide attempts, 48.48% use or used at least one drug, with alcohol, opioids, and benzodiazepines being the most common (6).
According to EUROSTAT, 7.8% of the European population has exhibited suicidal behavior at some point (7). Hesse et al. found that in a sample of 27,492 drug-dependent patients in Denmark, 2.3% attempted self-harm at least once in the past year, and 0.6% completed suicide. The main risk factors identified in this study were coexisting psychiatric disorders, previous suicide attempts, adolescence, cannabis use, and alcohol use (8).
In Chile, a sample of 550 adolescents was analyzed, within which 39% reported alcohol use, 32.9% tobacco use, and 30.9% marijuana use in the past month. It was also found that 27.5% exhibited suicidal ideation, 23.1% suicidal planning, and 20.9% had at least one suicide attempt. The risk factors identified for suicidal behavior were female gender, depression, hopelessness, anxiety, poor perception of physical well-being, poor relationship with parents and friends, low social support, and a poor school environment (9).
In Peru, an interesting observational, analytical, cross-sectional study aimed to determine the factors associated with suicidal ideation in patients in the Psychiatry Department of the Hospital María Auxiliadora. A population of 201 patients was analyzed, finding that 22.9% of the patients had suicidal ideation. Of the total population, 46.3% reported alcohol use, 26.4% tobacco use, and 9% psychoactive drug use. The main risk factors associated with suicidal behavior were female gender, absence of a partner, psychopharmacological treatment for over a year, and poor family relationships (10).
In summary, the data indicate that drug dependence and suicidal ideation are problems that generate severe consequences both nationally and internationally. While many of the risk factors associated with suicidal behavior are already known, these factors in the context of drug-dependent patients are still not well researched. This is particularly relevant when we understand that Peru is a multicultural country, where risk factors such as magical-religious beliefs, replacement of traditional treatment with alternative treatment, socioeconomic levels, among many others, are not taken into account in the most relevant literature. Furthermore, based on the results, we observe changes in the risk factors and their correlation with suicidal behavior when comparing different countries. Following this reasoning, risk factors could be heterogeneous depending on which natural region of our country is investigated. Therefore, exhaustive research will allow for adequate training of medical personnel specific to each region, thus enabling the development of prevention and treatment campaigns for drug-dependent patients with suicidal behavior.
It is recommended that more budget and personnel be allocated to research this problem, focusing on contextualizing the risk factors by natural regions, to improve prevention, treatment, and prognosis of suicidal behavior associated with drug dependence as a joint problem. Ignoring this crisis is to deny the reality of thousands of people who struggle daily against addiction and face an uncertain future marked by despair and hopelessness.
Authorship contributions:
The authors participated in the generation, collection of information, drafting, and final version of the original article.
Financing:
Self-funded
Declaration of conflict of interest:
The authors declare no conflict of interest in the publication of this article.
Recevied:
May 3, 2024
Approved:
June 23, 2024
Correspondence author:
Hector E. Leon
Address:
Av. Alfredo Benavides 5440, Santiago de Surco, Lima-Perú
Phone:
+51 950146904
E-mail:
leonsotoh@outlook.com
Article published by the Journal of the faculty of Human Medicine of the Ricardo Palma University. It is an open access article, distributed under the terms of the Creatvie Commons license: Creative Commons Attribution 4.0 International, CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/), that allows non-commercial use, distribution and reproduction in any medium, provided that the original work is duly cited. For commercial use, please contact revista.medicina@urp.edu.pe.
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