Use of alcohol before suicide in the United States

Ann Epidemiol. 2014 Aug;24(8):588-592.e1-2. doi: 10.1016/j.annepidem.2014.05.008. Epub 2014 May 23.


Purpose: Few studies have compared acute use of alcohol in suicide decedents with that in a nonsuicide group. This study provides the first national analysis of acute use of alcohol before suicide compared with an estimate of acute use of alcohol in a living sample.

Methods: Pooled 2003-2011 National Violent Death Reporting System data were used to estimate the prevalence of postmortem blood alcohol content positivity (blood alcohol content >0.0 g/dL) and intoxication (blood alcohol content ≥0.08 g/dL). Population estimates of comparable use of alcohol (within the past 48 hours) were based on the National Epidemiologic Survey on Alcohol and Related Conditions.

Results: Compared with the living sample, male and female suicide decedents showed, respectively, a 1.83-fold (95% confidence interval [CI], 1.73-1.93) and 2.40-fold (95% CI, 2.24-2.57) increased risk of alcohol ingestion before their death after age, race/ethnicity, and chronic alcohol problems were controlled. Furthermore, male and female decedents exhibited, respectively, a 6.18-fold (95% CI, 5.57-6.86) and a 10.04-fold (95% CI, 8.67-11.64) increased risk of being intoxicated before their death after confounders were considered.

Conclusions: The findings underscore the crucial need to include among the essential components of suicide prevention policies programs that minimize the use of alcohol, particularly drinking to intoxication.

Keywords: Alcohol drinking; Epidemiology; Suicide; Toxicology.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Alcoholic Intoxication / blood*
  • Alcoholic Intoxication / complications
  • Alcoholic Intoxication / epidemiology
  • Autopsy
  • Blood Chemical Analysis
  • Cause of Death
  • Databases, Factual
  • Ethanol / blood*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Sex Distribution
  • Suicide / statistics & numerical data*
  • United States / epidemiology
  • Young Adult


  • Ethanol