Factors associated with suicide in people who use drugs: a scoping review.
Drug use
Opioids
Risk factors
Sex
Suicide
Journal
BMC psychiatry
ISSN: 1471-244X
Titre abrégé: BMC Psychiatry
Pays: England
ID NLM: 100968559
Informations de publication
Date de publication:
05 09 2023
05 09 2023
Historique:
received:
16
03
2023
accepted:
23
08
2023
medline:
7
9
2023
pubmed:
6
9
2023
entrez:
5
9
2023
Statut:
epublish
Résumé
Suicide is a significant contributor to global mortality. People who use drugs (PWUD) are at increased risk of death by suicide relative to the general population, but there is a lack of information on associated candidate factors for suicide in this group. The aim of this study was to provide a comprehensive overview of existing evidence on potential factors for death by suicide in PWUD. A scoping review was conducted according to the Arksey and O'Malley framework. Articles were identified using Medline, CINAHL, PsycINFO, SOCIndex, the Cochrane Database of Systematic Reviews and the Campbell Collaboration Database of Systematic Reviews; supplemented by grey literature, technical reports, and consultation with experts. No limitations were placed on study design. Publications in English from January 2000 to December 2021 were included. Two reviewers independently screened full-text publications for inclusion. Extracted data were collated using tables and accompanying narrative descriptive summaries. The review was reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. The initial search identified 12,389 individual publications, of which 53 met the inclusion criteria. The majority (87%) of included publications were primary research, with an uncontrolled, retrospective study design. The most common data sources were drug treatment databases or national death indexes. Eleven potential factors associated with death by suicide among PWUD were identified: sex; mental health conditions; periods of heightened vulnerability; age profile; use of stimulants, cannabis, or new psychoactive substances; specific medical conditions; lack of dual diagnosis service provision; homelessness; incarceration; intravenous drug use; and race or ethnicity. Opioids, followed by cannabis and stimulant drugs were the most prevalent drugs of use in PWUD who died by suicide. A large proportion of evidence was related to opioid use; therefore, more primary research on suicide and explicit risk factors is required. The majority of studies exploring factors associated with death by suicide among PWUD involved descriptive epidemiological data, with limited in-depth analyses of explicit risk factors. To prevent suicide in PWUD, it is important to consider potential risk factors and type of drug use, and to tailor policies and practices accordingly.
Sections du résumé
BACKGROUND
Suicide is a significant contributor to global mortality. People who use drugs (PWUD) are at increased risk of death by suicide relative to the general population, but there is a lack of information on associated candidate factors for suicide in this group. The aim of this study was to provide a comprehensive overview of existing evidence on potential factors for death by suicide in PWUD.
METHODS
A scoping review was conducted according to the Arksey and O'Malley framework. Articles were identified using Medline, CINAHL, PsycINFO, SOCIndex, the Cochrane Database of Systematic Reviews and the Campbell Collaboration Database of Systematic Reviews; supplemented by grey literature, technical reports, and consultation with experts. No limitations were placed on study design. Publications in English from January 2000 to December 2021 were included. Two reviewers independently screened full-text publications for inclusion. Extracted data were collated using tables and accompanying narrative descriptive summaries. The review was reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines.
RESULTS
The initial search identified 12,389 individual publications, of which 53 met the inclusion criteria. The majority (87%) of included publications were primary research, with an uncontrolled, retrospective study design. The most common data sources were drug treatment databases or national death indexes. Eleven potential factors associated with death by suicide among PWUD were identified: sex; mental health conditions; periods of heightened vulnerability; age profile; use of stimulants, cannabis, or new psychoactive substances; specific medical conditions; lack of dual diagnosis service provision; homelessness; incarceration; intravenous drug use; and race or ethnicity. Opioids, followed by cannabis and stimulant drugs were the most prevalent drugs of use in PWUD who died by suicide. A large proportion of evidence was related to opioid use; therefore, more primary research on suicide and explicit risk factors is required.
CONCLUSIONS
The majority of studies exploring factors associated with death by suicide among PWUD involved descriptive epidemiological data, with limited in-depth analyses of explicit risk factors. To prevent suicide in PWUD, it is important to consider potential risk factors and type of drug use, and to tailor policies and practices accordingly.
Identifiants
pubmed: 37670233
doi: 10.1186/s12888-023-05131-x
pii: 10.1186/s12888-023-05131-x
pmc: PMC10478413
doi:
Substances chimiques
Hallucinogens
0
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
655Informations de copyright
© 2023. BioMed Central Ltd., part of Springer Nature.
Références
World Health Organization. Preventing suicide: a global imperative. Geneva: WHO. ; 2014. Available from: https://www.who.int/publications/i/item/9789241564779 (Accessed 15 Mar. 23).
Naghavi M. Global, regional, and national burden of suicide mortality 1990 to 2016: systematic analysis for the global burden of Disease Study 2016. BMJ. 2019;364:l94.
pubmed: 31339847
pmcid: 6598639
World Health Organization. Suicide worldwide in 2019: Global Health Estimates. Geneva: WHO. ; 2021 Jun. Available from: https://www.who.int/publications/i/item/9789240026643 (Accessed 15 Mar. 23).
Crosby A, Ortega L, Melanson C, Division of Violence Prevention. Self-directed violence surveillance; uniform definitions and recommended data elements. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, ; 2011. Available from: https://stacks.cdc.gov/view/cdc/11997 (Accessed 15 Mar. 23).
Esang M, Ahmed S. A closer look at substance use and suicide. Am J Psychiatry Res J. 2018;13(6).
Favril L, Yu R, Uyar A, Sharpe M, Fazel S. Risk factors for suicide in adults: systematic review and meta-analysis of psychological autopsy studies. Evid Based Ment Health. 2022;25(4):148.
pubmed: 36162975
pmcid: 9685708
Stone DM, Crosby AE. Suicide Prevention: state of the Art Review. Am J Lifestyle Med. 2014;8(6):404–20.
pubmed: 30166972
Turecki G, Brent DA. Suicide and suicidal behaviour. Lancet. 2016;387(10024):1227–39.
pubmed: 26385066
Diekstra R, Gulbinat W. The epidemiology of suicidal behaviour: a review of three continents. World Health Stat Q. 1993;46(1):52–68.
pubmed: 7694430
Freeman A, Mergl R, Kohls E, Székely A, Gusmao R, Arensman E, et al. A cross-national study on gender differences in suicide intent. BMC Psychiatry. 2017;17(1):234.
pubmed: 28662694
pmcid: 5492308
Spillane A, Matvienko-Sikar K, Larkin C, Corcoran P, Arensman E. What are the physical and psychological health effects of suicide bereavement on family members? An observational and interview mixed-methods study in Ireland. BMJ Open. 2018;8(1):e019472.
pubmed: 29331974
pmcid: 5781012
Cerel J, Maple M, van de Venne J, Moore M, Flaherty C, Brown M. Exposure to suicide in the community: prevalence and correlates in one U.S. state. Public Health Rep. 2016;131(1):100–7.
pubmed: 26843675
pmcid: 4716477
McDaid C, Trowman R, Golder S, Hawton K, Sowden A. Interventions for people bereaved through suicide: systematic review. Br J Psychiatry. 2008;193(6):438–43.
pubmed: 19043143
Kennelly B. The economic cost of suicide in Ireland. Crisis. 2007;28(2):89–94.
pubmed: 17722690
Yang B, Lester D. Recalculating the economic cost of suicide. Death Stud. 2007;31(4):351–61.
pubmed: 17378112
World Health Organization. Comprehensive Mental Health Action Plan 2013–2030. Geneva: WHO. ; 2021. Available from: https://www.who.int/publications/i/item/9789240031029 (Accessed 15 Mar. 23).
Cantor CH, Baume PJ. Suicide prevention: a public health approach. Aust N Z J Ment Health Nurs. 1999;8(2):45–50.
pubmed: 10661071
Cavanagh JTO, Carson AJ, Sharpe M, Lawrie SM. Psychological autopsy studies of suicide: a systematic review. Psychol Med. 2003;33(3):395–405.
pubmed: 12701661
Yuodelis-Flores C, Ries RK. Addiction and suicide: a review. Am J Addict. 2015;24(2):98–104.
pubmed: 25644860
Hesse M, Thylstrup B, Seid AK, Skogen JC. Suicide among people treated for drug use disorders: a danish national record-linkage study. BMC Public Health. 2020;20(1):146.
pubmed: 32005222
pmcid: 6995113
Lynch FL, Peterson EL, Lu CY, Hu Y, Rossom RC, Waitzfelder BE, et al. Substance use disorders and risk of suicide in a general US population: a case control study. Addict Sci Clin Pract. 2020;15(1):14.
pubmed: 32085800
pmcid: 7035727
Harris EC, Barraclough B. Suicide as an outcome for mental disorders. A meta-analysis. Br J Psychiatry. 1997;170:205–28.
pubmed: 9229027
Wilcox HC, Conner KR, Caine ED. Association of alcohol and drug use disorders and completed suicide: an empirical review of cohort studies. Drug Alcohol Depend. 2004;76 Suppl:S11-19.
Bohnert KM, Ilgen MA, Louzon S, McCarthy JF, Katz IR. Substance use disorders and the risk of suicide mortality among men and women in the US Veterans Health Administration. Addiction. 2017;112(7):1193–201.
pubmed: 28301070
Darke S, Ross J. Suicide among heroin users: rates, risk factors and methods. Addiction. 2002;97(11):1383–94.
pubmed: 12410779
Schneider B. Substance use disorders and risk for completed suicide. Arch Suicide Res. 2009;13(4):303–16.
pubmed: 19813108
Degenhardt L, Singleton J, Calabria B, McLaren J, Kerr T, Mehta S, et al. Mortality among cocaine users: a systematic review of cohort studies. Drug Alcohol Depend. 2011;113(2–3):88–95.
pubmed: 20828942
Vijayakumar L, Kumar MS, Vijayakumar V. Substance use and suicide. Curr Opin Psychiatry. 2011;24(3):197–202.
pubmed: 21430536
Bohnert ASB, Roeder K, Ilgen MA. Unintentional overdose and suicide among substance users: a review of overlap and risk factors. Drug Alcohol Depend. 2010;110(3):183–92.
pubmed: 20430536
Degenhardt L, Bucello C, Mathers B, Briegleb C, Ali H, Hickman M, et al. Mortality among regular or dependent users of heroin and other opioids: a systematic review and meta-analysis of cohort studies. Addiction. 2011;106(1):32–51.
pubmed: 21054613
Poorolajal J, Haghtalab T, Farhadi M, Darvishi N. Substance use disorder and risk of suicidal ideation, suicide attempt and suicide death: a meta-analysis. J Public Health (Oxf). 2016;38(3):e282–91.
pubmed: 26503486
Mann JJ, Apter A, Bertolote J, Beautrais A, Currier D, Haas A, et al. Suicide Prevention Strategies: a systematic review. JAMA. 2005;294(16):2064–74.
pubmed: 16249421
Colquhoun HL, Levac D, O’Brien KK, Straus S, Tricco AC, Perrier L, et al. Scoping reviews: time for clarity in definition, methods, and reporting. J Clin Epidemiol. 2014;67(12):1291–4.
pubmed: 25034198
Peters MDJ. In no uncertain terms: the importance of a defined objective in scoping reviews. JBI Database System Rev Implement Rep. 2016;14(2):1–4.
pubmed: 27536788
Peters MDJ, Marnie C, Tricco AC, Pollock D, Munn Z, Alexander L, McInerney P, Godfrey CM, Khalil H. Updated methodological guidance for the conduct of scoping reviews. JBI Evid Synth. 2020;18(10):2119–26.
pubmed: 33038124
Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19–32.
Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for scoping reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018;169(7):467–73.
pubmed: 30178033
Murphy L, Lyons S, O’Sullivan M, Lynn E. Risk factors for completed suicide among people who use drugs: a scoping review protocol [version 3; peer review: 2 approved, 1 approved with reservations]. HRB Open Res. 2021;3(45).
Peters MDJ, Godfrey CM, McInerney P, Munn Z, Tricco AC, Khalil H. Chapter 11: Scoping Reviews (2020 version). In: Aromataris E, Munn Z, editors. JBI Manual for Evidence Synthesis. JBI; 2020. Available from: https://synthesismanual.jbi.global (Accessed 15 Mar. 23).
Thomas J, Brunton J, Graziosi S. EPPI-Reviewer 4.0: software for research synthesis. London: Social Science Research Unit, Institute of Education, University of London; 2010.
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71.
pubmed: 33782057
pmcid: 8005924
Hjorthoj C, Ostergaard MLD, Benros ME, Toftdahl NG, Erlangsen A, Andersen JT, et al. Association between alcohol and substance use disorders and all-cause and cause-specific mortality in schizophrenia, bipolar disorder, and unipolar depression: a nationwide, prospective, register-based study. Lancet Psychiatry. 2015;2(9):801–8.
pubmed: 26277044
Flynn S, Graney J, Nyathi T, Raphael J, Abraham S, Singh-Dernevik S, et al. Clinical characteristics and care pathways of patients with personality disorder who died by suicide. BJPsych Open. 2020;6(2):e29.
pmcid: 7176898
Hentzien M, Cabie A, Pugliese P, Billaud E, Poizot-Martin I, Duvivier C, et al. Factors associated with deaths from suicide in a french nationwide HIV-infected cohort. HIV Med. 2018;19:551–8.
Sheehan CM, Rogers RG, Boardman JD. Postmortem Presence of drugs and method of violent suicide. J Drug Issues. 2015;45(3):249–62.
pubmed: 27239069
pmcid: 4880407
Zaheer J, Olfson M, Mallia E, Lam JSH, de Oliveira C, Rudoler D, et al. Predictors of suicide at time of diagnosis in schizophrenia spectrum disorder: a 20-year total population study in Ontario, Canada. Schizophr Res. 2020;222:382–8.
pubmed: 32507375
Kung HC, Pearson JL, Liu X. Risk factors for male and female suicide decedents ages 15–64 in the United States. Results from the 1993 National Mortality Followback Survey. Soc Psychiatry Psychiatr Epidemiol. 2003;38(8):419–26.
pubmed: 12910337
Mackenzie N, Oram C, Borrill J. Self-inflicted deaths of women in custody. Br J Forensic Pract. 2003;5:27–35.
Adams RS, Jiang T, Rosellini AJ, Horvath-Puho E, Street AE, Keyes KM, et al. Sex-specific risk profiles for suicide among persons with Substance Use Disorders in Denmark. Addiction. 2021;116(10):2882–92.
pubmed: 33620758
pmcid: 8459184
Myhre MO, Kildahl AT, Walby FA. Suicide after contact with substance misuse services: a national registry study. BJPsych Open. 2020;6(3):e45.
pubmed: 32375917
pmcid: 7331082
Feodor Nilsson S, Hjorthoj CR, Erlangsen A, Nordentoft M. Suicide and unintentional injury mortality among homeless people: a danish nationwide register-based cohort study. Eur J Public Health. 2014;24(1):50–6.
pubmed: 23482619
Willis LA, Coombs DW, Drentea P, Cockerham WC. Uncovering the mystery: factors of african american suicide. Suicide Life Threat Behav. 2003;33(4):412–29.
pubmed: 14695056
Arnautovska U, Sveticic J, De Leo D. What differentiates homeless persons who died by suicide from other suicides in Australia? A comparative analysis using a unique mortality register. Soc Psychiatry Psychiatr Epidemiol. 2014;49(4):583–9.
pubmed: 24100916
Darke S, Marel C, Mills KL, Ross J, Slade T, Tessson M. Years of potential life lost amongst heroin users in the australian treatment outcome study cohort, 2001–2015. Drug Alcohol Depend. 2016;162:206–10.
pubmed: 27021806
Zahra E, Darke S, Degenhardt L, Campbell G. Rates, characteristics and manner of cannabis-related deaths in Australia 2000–2018. Drug Alcohol Depend. 2020;212:108028.
pubmed: 32370933
Colell E, Domingo-Salvany A, Espelt A, Parés-Badell O, Brugal MT. Differences in mortality in a cohort of cocaine use disorder patients with concurrent alcohol or opiates disorder. Addiction. 2018;113(6):1045–55.
pubmed: 29357115
Darke S, Kaye S, Duflou J, Lappin J. Completed suicide among methamphetamine users: a National Study. Suicide Life Threat Behav. 2019;49(1):328–37.
pubmed: 29444345
Bartu A, Freeman NC, Gawthorne GS, Codde JP, Holman CDJ. Mortality in a cohort of opiate and amphetamine users in Perth, Western Australia. Addiction. 2004;99(1):53–60.
pubmed: 14678062
Elliott S, Evans J. A 3-year review of new psychoactive substances in casework. Forensic Sci Int. 2014;243:55–60.
pubmed: 24810679
Delaveris GJM, Teige B, Rogde S. Non-natural manners of death among users of illicit drugs: substance findings. Forensic Sci Int. 2014;238:16–21.
pubmed: 24637034
Merrall ELC, Bird SM, Hutchinson SJ. A record-linkage study of drug-related death and suicide after hospital discharge among drug-treatment clients in Scotland, 1996–2006. Addiction. 2013;108(2):377–84.
pubmed: 22925008
Stenbacka M, Leifman A, Romelsjo A. Mortality and cause of death among 1705 illicit drug users: a 37 year follow up. Drug Alcohol Rev. 2010;29(1):21–7.
pubmed: 20078678
Onyeka IN, Beynon CM, Vohlonen I, Tiihonen J, Fohr J, Ronkainen K, et al. Potential years of Life Lost due to premature mortality among treatment- seeking Illicit Drug users in Finland. J Community Health. 2015;40(6):1099–106.
pubmed: 25967278
Hayashi K, Dong H, Marshall BDL, Milloy MJ, Montaner JSG, Wood E, et al. Sex-based differences in Rates, causes, and predictors of death among injection drug users in Vancouver, Canada. Am J Epidemiol. 2016;183(6):544–52.
pubmed: 26865265
pmcid: 4782762
Pfeifer P, Nigg-Trawally N, Bartsch C, Reisch T. Characteristics of Suicides and Toxicology in a cohort of individuals with opioid Use Disorder. Arch Suicide Res. 2021;25(2):287–96.
pubmed: 32281522
Zamparutti G, Schifano F, Corkery JM, Oyefeso A, Ghodse AH. Deaths of opiate/opioid misusers involving dihydrocodeine, UK, 1997–2007. Br J Clin Pharmacol. 2011;72(2):330–7.
pubmed: 21235617
pmcid: 3162662
Riblet NB, Gottlieb DJ, Shiner B, Cornelius SL, Watts BV. Associations between Medication assisted Therapy Services Delivery and Mortality in a National Cohort of Veterans with posttraumatic stress disorder and opioid use disorder. J Dual Diagn. 2020;16(2):228–38.
pubmed: 31852392
Maxwell JC, Pullum TW, Tannert K. Deaths of clients in methadone treatment in Texas: 1994–2002. Drug Alcohol Depend. 2005;78(1):73–81.
pubmed: 15769560
Chang KC, Lu TH, Lee KY, Hwang JS, Cheng CM, Wang JD. Estimation of life expectancy and the expected years of life lost among heroin users in the era of opioid substitution treatment (OST) in Taiwan. Drug Alcohol Depend. 2015;153:152–8.
pubmed: 26054944
Mercedes L, Lovrecic B, Maremmani I, Maremmani AG. Excess suicide mortality in Heroin Use Disorder patients seeking opioid agonist treatment in Slovenia and risk factors for suicide. Heroin Addict Relat Clin Probl. 2018;20(2):35–40.
Degenhardt L, Randall D, Hall W, Law M, Butler T, Burns L. Mortality among clients of a state-wide opioid pharmacotherapy program over 20 years: risk factors and lives saved. Drug Alcohol Depend. 2009;105(1–2):9–15.
pubmed: 19608355
Cao X, Wu Z, Li L, Pang L, Rou K, Wang C, et al. Mortality among methadone maintenance clients in China: a six-year cohort study. PLoS ONE. 2013;8(12):e82476.
pubmed: 24349294
pmcid: 3861403
Larney S, Gisev N, Farrell M, Dobbins T, Burns L, Gibson A, et al. Opioid substitution therapy as a strategy to reduce deaths in prison: retrospective cohort study. BMJ Open. 2014;4(4):e004666.
pubmed: 24694626
pmcid: 3987723
Kelty E, Hulse G. Self-Injuring Behavior and Mental illness in opioid-dependent patients treated with Implant Naltrexone, Methadone, and Buprenorphine in Western Australia. Int J Ment Health Addict. 2018;16(1):187–98.
Lee CTC, Chen VCH, Tan HKL, Chou SY, Wu KH, Chan CH, et al. Suicide and other-cause mortality among heroin users in Taiwan: a prospective study. Addict Behav. 2013;38(10):2619–23.
pubmed: 23851391
Chen WT, Wang SC, Wang IA, Tsay JH, Chen CY. Suicide attempts and death among heroin-involved women seeking methadone treatment in Taiwan. Drug Alcohol Depend. 2020;217:108277.
pubmed: 32971389
Vajdic CM, Marashi Pour S, Olivier J, Swart A, O’Connell DL, Falster MO, et al. The impact of blood-borne viruses on cause-specific mortality among opioid dependent people: an australian population-based cohort study. Drug Alcohol Depend. 2015;152:264–71.
pubmed: 25936861
Gibson A, Randall D, Degenhardt L. The increasing mortality burden of liver disease among opioid-dependent people: cohort study. Addiction. 2011;106(12):2186–92.
pubmed: 21749525
Madadi P, Hildebrandt D, Lauwers AE, Koren G. Characteristics of opioid-users whose death was related to opioid- toxicity: a population-based study in Ontario, Canada. PLoS ONE. 2013;8(4):e60600.
pubmed: 23577131
pmcid: 3618438
Pan CH, Jhong JR, Tsai SY, Lin SK, Chen CC, Kuo CJ. Excessive suicide mortality and risk factors for suicide among patients with heroin dependence. Drug Alcohol Depend. 2014;145:224–30.
pubmed: 25456334
Degenhardt L, Larney S, Randall D, Burns L, Hall W. Causes of death in a cohort treated for opioid dependence between 1985 and 2005. Addiction. 2014;109(1):90–9.
pubmed: 23961881
Pavarin RM, Sanchini S, Marani S, Turino E, Tadonio L, Cantarelli B. Mortality risk among heroin users accessing treatment: natives and non- natives patients results of a longitudinal study. J Psychoact Drugs. 2020;52(2):176–85.
Pavarin RM, Fioritti A. Mortality Trends among Cocaine users treated between 1989 and 2013 in Northern Italy: results of a longitudinal study. J Psychoact Drugs. 2018;50(1):72–80.
Pavarin RM, Fioritti A, Sanchini S. Mortality trends among heroin users treated between 1975 and 2013 in Northern Italy: results of a longitudinal study. J Subst Abuse Treat. 2017;77:166–73.
pubmed: 28237351
Degenhardt L, Grebely J, Stone J, Hickman M, Vickerman P, Marshall BDL, et al. Global patterns of opioid use and dependence: harms to populations, interventions, and future action. Lancet. 2019;394(10208):1560–79.
pubmed: 31657732
pmcid: 7068135
Borges G, Bagge CL, Orozco R. A literature review and meta-analyses of cannabis use and suicidality. J Affect Disord. 2016;195:63–74.
pubmed: 26872332
European Monitoring Centre for Drugs and Drug Addiction. Mortality related to drug use in Europe: public health implications: EMCDDA Selected issues. Publications Office. ; 2011. Available from: https://data.europa.eu/doi/10.2810/49713 (Accessed 15 Mar. 23).
Bohnert ASB, Ilgen MA. Understanding links among opioid use, overdose, and suicide. N Engl J Med. 2019;380(1):71–9.
pubmed: 30601750
Appleby L. Drug misuse and suicide: a tale of two services. Addiction. 2000;95(2):175–7.
pubmed: 10723839
Kelly K, Holahan R, Dual Recovery. A qualitative exploration of the views of stakeholders working in mental health, substance use, and homelessness in Ireland on the barriers to recovery for individuals with a Dual Diagnosis. Dublin: Mental Health Reform; 2022. Available from: https://www.mentalhealthreform.ie/wp-content/uploads/2022/05/Dual-Recovery-Full-Report.pdf (Accessed 15 Mar. 23).
Ivers JH, Zgaga L, O’Donoghue-Hynes B, Heary A, Gallwey B, Barry J. Five-year standardised mortality ratios in a cohort of homeless people in Dublin. BMJ Open. 2019;9(1):e023010.
pubmed: 30782692
pmcid: 6352814
Baggett TP, Hwang SW, O’Connell JJ, Porneala BC, Stringfellow EJ, Orav EJ, et al. Mortality among homeless adults in Boston: shifts in causes of death over a 15-year period. JAMA Intern Med. 2013;173(3):189–95.
pubmed: 23318302
pmcid: 3713619
O’Connell JJ. Premature mortality in homeless populations: a review of the literature. Nashville: National Health Care for the Homeless Council, Inc.; 2005. Available from: http://sbdww.org/wp-content/uploads/2011/04/PrematureMortalityFinal.pdf (Accessed 15 Mar. 23).
Turecki G, Brent DA, Gunnell D, O’Connor RC, Oquendo MA, Pirkis J, et al. Suicide and suicide risk. Nat Rev Dis Primers. 2019;5(1):74.
pubmed: 31649257
United Nations. Department of Economic and Social Affairs: Sustainable Development Goal 5. Achieve gender equality and empower all women and girls. 2021. Avaiable from: https://sustainabledevelopment.un.org/sdg5 (Accessed 01 Jun. 2023).
Lynn E, Doyle A, Keane M, Bennett K, Cousins G. Drug poisoning deaths among women: a scoping review. J Stud Alcohol Drugs. 2020;81(5):543–55.
pubmed: 33028464
Morton S, Macdonald S, Christophers L. Responding to women with complex needs who use substances. Dublin: University College Dublin; 2020. Available from: https://researchrepository.ucd.ie/bitstream/10197/11712/2/Responding%20to%20women%20with%20complex%20needs%20who%20use%20substances.pdf (Accessed 15 Mar. 23).
United Nations Office on Drugs and Crime. World Drug Report 2018: Women and Drugs: Drug use, drug supply and their consequences. Vienna: UNODC. ; 2018. Available from: https://unodc.org/wdr2018/prelaunch/WDR18_Booklet_5_WOMEN.pdf (Accessed 15 Mar. 23).
Yur’yev A, Värnik P, Sisask M, Leppik L, Lumiste K, Värnik A. Some aspects of social exclusion: do they influence suicide mortality? Int J Soc Psychiatry. 2013;59(3):232–8.
pubmed: 22205377
McGinty EE, Daumit GL. Integrating Mental Health and Addiction Treatment Into General Medical Care: the role of policy. Psychiatr Serv. 2020;71(11):1163–9.
pubmed: 32487007
pmcid: 7606646
National Working Group for Dual Diagnosis. Model of Care for People with Mental Disorder and Co-existing Substance Use Disorder (Dual Diagnosis). Health Service Executive; 2023 May. Report No.: CDI006/2022. Available from: https://www.hse.ie/eng/about/who/cspd/ncps/mental-health/dual-diagnosis-ncp/dual-diagnosis-model-of-care.pdf .
Varnik A, Sisask M, Varnik P, Wu J, Kolves K, Arensman E, et al. Drug suicide: a sex-equal cause of death in 16 european countries. BMC Public Health. 2011;11(1):61.
pubmed: 21276260
pmcid: 3038157
Dumais A, Lesage AD, Alda M, Rouleau G, Dumont M, Chawky N, et al. Risk factors for suicide completion in Major Depression: a case-control study of impulsive and aggressive behaviors in men. Am J Psychiatry. 2005;162(11):2116–24.
pubmed: 16263852
Sallis JF, Owen N, Fisher EB. Ecological models of health behavior. In: Glanz K, Rimer BK, Viswanath K, editors. Health behavior and health education. 4th ed. San Francisco: John Wiley & Sons; 2008. pp. 465–85.
Madden A, Tanguay P, Chang J, Drug, Decriminalisation. Progress or Political Red Herring? International Network of People who Use Drugs. 2021. Available from: https://inpud.net/drug-decriminalisation-progress-or-political-red-herring/ (Accessed 01 Jun. 2023).
Walker I, Netherland J. Developing a transformative drug Policy Research Agenda in the United States. Contemp Drug Probl 201946(1):3–21.
Hoss A. Decriminalization as Substance Use Disorder Prevention. U Tol L Rev. 2019;51:477.