Drug overdoses may cause discrepancies in numbers
MORGANTOWN, W.Va. – Ian Rockett, Ph.D, M.P.H., professor of epidemiology and associate chair of the West Virginia University Department of Community Medicine, isn't buying the story the suicide numbers are telling.
National mortality data from WISQARS, the Web-based Injury Statistics Query and Reporting System maintained by the Centers for Disease Control and Prevention, show an 18 percent decline in the suicide rate between 1987 and 2000. Dr. Rockett believes this is a serious overestimate. He also believes the 10 percent increase between 2000 and 2007, the most recent data available, is a serious underestimate.
“Suicides are likely being hidden within the epidemic of prescription and nonprescription drug overdoses. Most medical examiner and coroner offices are probably nowhere near well enough resourced to properly investigate intentionality of decedents,” Rockett said. “They probably do much better with homicide than suicide because of the assistance from the police. There is no equivalent agency to the police to help medical examiners and coroners investigate possible suicides.”
Rockett's research indicates that any suicide misclassification related to poisoning or drug overdose mainly affects people under age 65. “From a viewpoint of more accurately reporting the full extent of injury deaths due to self-harm in the United States, it may make sense to combine official suicides and non-suicide deaths from drug overdoses. In better measuring the true burden of self-destruction from injury, this would strengthen prevention efforts to address both suicide and drug-overdose deaths, and non-fatal self-harm as well,” he said.
The good news, Rockett added, is that the suicide rate for the elderly population has dropped sharply in 20 years.
“There appears to have been true major declines between 1987 and 2006 in the suicide rate for the elderly, that is, the population age 65 and older,” he said. “The suicide rate for elderly men – the group with the highest official suicide rate – declined by 35 percent. The rate decline for elderly females was even more impressive at 43 percent.”
Rockett published this research in a paper titled, “Suicide and unintentional poisoning mortality trends in the United States, 1987-2006: Two unrelated phenomena?,” with three colleagues from WVU and four others from the United States and overseas.
WVU researchers include Alan Ducatman, M.D., chair of Community Medicine; James Frost, M.D., Department of Pathology; and Gerry Hobbs, Ph.D., Department of Statistics.
Other authors include:
• Diego De Leo, M.D., Ph.D., Griffith University, Australia
• Nestor Kapusta, M.D., Medical University of Vienna, Austria
• Steven Sack, Ph.D., Wayne State University
• Rheeda Walker, Ph.D., University of Georgia
The study was published Nov. 17 in the online open-access medical journal, “BMC Public Health,” which is based in London. It can be viewed at www.biomedcentral.com/content/pdf/1471-2458-10-705.pdf.
For more information on the WVU Department of Community Medicine see www.hsc.wvu.edu/som/cmed.