Age and gender differences in patterns of alcohol use preceding suicide: Findings from the 2003-10 national violent death reporting system

Suicide is the 10th leading cause of death overall in the United States. Chronic alcohol use is widely regarded as a risk factor for suicide, but acute alcohol use is also essential to consider as an important factor in suicidal behaviors. Little is known about the patterns of alcohol involvement based on alcohol consumption immediately before death particularly among men and women across the age span. This study aimed to estimate post-mortem blood alcohol concentration (BAC) levels and the prevalence of alcohol dependence (as a circumstance preceding death) among suicide decedents in the United States by gender and age. Data derived from the National Violent Death Reporting System, an 18-state active surveillance system that provides a detailed account of violent deaths, including alcohol toxicology data, for 50,437 male and female suicide decedents in 2003-10. The measures of interest included postmortem blood alcohol content (BAC>0 and BAC≥0.08g/dl) prior to death and known alcohol dependence (AD). Overall, male decedents were more likely to be BAC+ at time of death than their female counterparts, except in the youngest (<21 years) and oldest (≥65 years). Nearly 70% of all BAC+ suicide decedents had BAC levels at or above .08g/dl. Fewer than 45% of male and female suicide decedents BAC+ were known to have had a history of AD prior to their death. These results point to unmet public health needs, particularly the high prevalence of acute use of alcohol prior to death among male and female suicide decedents across the age span.