Psychoactive substances use before suicide: detailed analysis of all cases that occurred in the Brazilian Federal District in a 10-years period

Abstract Background: Psychoactive substances (PASs) are an important risk factor for the suicide. This study investigated the sociodemographic characteristics, the methods employed, the circumstances of the events, and the use of PASs in all suicides that occurred between 2005-2014 in the Brazilian Federal District, besides to compare cases with positive and negative detection for PASs in the post-mortem analysis. Methods: A population-based, observational, cross-sectional study with an analytical aspect was conducted with suicides cases collected from local police, which toxicological examination was performed (headspace gas chromatographic-mass spectrometry-HS-GC/MS) for detection of ethanol and methanol in blood samples; immunoassay for other substances (cocaine, marijuana, benzodiazepines, etc.). Results: The results showed that the increase in the suicide rate was 10x greater than the population growth and 44% of the individuals used PASs before suicide. Individuals are more likely to die by suicide at home, to be male, to have tried before and to change their behaviour days before death; they chose hanging as the method and are under the influence of alcohol. Conclusion: Identifying what sociodemographic characteristics are associated with a fatal suicide attempt among individuals who use PASs and those who do not use, as well as among those who have/not have mental disorders and what methods are employed, could be a path to better interventions. Thus, prevention actions could be planned and directed to individuals with greater risk.