Suicidal thoughts and behaviors among untreated illicit substance users: a population-based study

Ramin Shiraly; Seyed Amin Jazayeri; Asal Seifaei; Ali Khani Jeihooni; Mark D Griffiths

doi:10.1186/s12954-024-01015-9

Suicidal thoughts and behaviors among untreated illicit substance users: a population-based study

Harm Reduct J. 2024 May 16;21(1):96. doi: 10.1186/s12954-024-01015-9.

Authors

Ramin Shiraly¹, Seyed Amin Jazayeri², Asal Seifaei², Ali Khani Jeihooni³, Mark D Griffiths⁴

Affiliations

¹ Community Medicine Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. rshiraly@gmail.com.
² Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
³ Nutrition Research Center, Public Health Department, Shiraz University of Medical Sciences, Shiraz, Iran.
⁴ International Gaming Research Unit, Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK.

Abstract

Objectives: Research regarding the contribution of specific psychoactive substances to suicidality has yielded equivocal results. The present study examined the prevalence and factors associated with suicidal thoughts and behaviors among a population-based sample of untreated illicit substance users.

Methods: A total of 616 illicit substance users who were recruited from high-risk areas of Shiraz using snowball sampling participated in the study. Eligible participants were individuals aged 18 years and older who regularly used one illicit psychoactive substance (e.g., opioids, heroin, cannabinoids, stimulants, hallucinogens) for at least one year and who had received no treatment for their drug use during the past year. Data were collected regarding socio-demographic characteristics, mental history, and substance use habits. Data regarding suicidal thoughts and behaviors were assessed using the Beck Suicidal Ideation Scale (BSIS) and self-reports of previous suicide attempts. Multiple logistic regression analysis was used to identify independent variables associated with suicidality.

Results: Among the participants, 23.6% reported having had suicidal thoughts during the past week and 6.7% reported having attempted suicide during the past year. Methamphetamine was reported as the primary substance of use among approximately half of the participants who attempted suicide during past year (49.2%). Multiple logistic regression analysis showed that current suicidal thoughts were independently associated with having no job, a history of mental health condition, previous suicidal attempts, concurrent use of more than one substance, and using methamphetamine and heroin as the primary substances. Suicidal thoughts were not associated with increased odds of regular opium and cannabis use.

Conclusion: Both methamphetamine and heroin use are significantly associated with current suicidal thoughts. Evaluation of the risk of suicidality by physicians and mental health care professionals in both community and outpatient settings would be especially appropriate among those individuals using these psychoactive substances.

Keywords: Attempted suicide; Heroin; Illicit substance use; Methamphetamine; Suicidal ideation.

MeSH terms

Adolescent
Adult
Female
Humans
Illicit Drugs
Iran / epidemiology
Male
Middle Aged
Prevalence
Risk Factors
Substance-Related Disorders* / epidemiology
Substance-Related Disorders* / psychology
Suicidal Ideation*
Suicide, Attempted* / psychology
Suicide, Attempted* / statistics & numerical data
Young Adult