Investigating Toxicology Results among Suicide Victims in Upstate New York

Kristen Berish and Jennifer Bready, Ph.D.

Division of Mathematics
Mount Saint Mary College, Newburgh NY, 12550

Introduction
In 2013, 41,149 people committed suicide,
making suicide the tenth leading cause of death
across all ages in the United States [1]. National
data, collected by the CDC, on suicide victims is used
by researchers and the public to monitor trends and
identify problems among these victims in order to aid
in the prevention of suicide.
In this study, we examined trends among
suicide victims in Dutchess County. The primary aim
of this study was to find and discuss the link between
suicide and alcohol consumption and drug use, both
individually and collectively, by examining the victims
postmortem toxicology.
Postmortem toxicology tests
of suicide victims are used to
identify the presence of toxins,
which include alcohol, prescription
drugs, and drugs of dependence
that may have been taken prior to
death. Alcohol is considered a
potential risk factor of suicide
among men and women of all age
groups. Research shows that
acute alcohol use is present in at
Figure 1: Vials of blood being sent out for toxicology
least one third of suicides across
all methods of death [2]. Drug use, both legal and
illegal, can also be considered a potential risk factor
of suicide among men and women. Opiates and
antidepressants are most commonly associated with
suicide with women being the most commonly testing
positive for each [3].

Materials and Methods

Cases were sorted into variables which include
the deceaseds gender, age, race, reported case date,
method of suicide, weapon used, whether a suicide
note was left, and the victims toxicology results.
Method of death categories:
Gunshot wound
Suffocation and hanging
Poison
Other.
Toxicology results were broken down into the
following categories:
If a toxicology test was done
If the test came back positive or negative,
If the victim had alcohol, illicit drugs, or
prescription drugs
Type and amount of drug found

Results

Chi-Square analysis shows no differences among

percentages within the categories of method of death
and alcohol presence. (2 = .401, = 3, = .904)

Results
There were 326 suicide victims with 254 males
and 72 females ranging in age from 14 to 94 in this
study that were analyzed. Shown in the graph below is
the distribution of males in females in each method of
death category.
Chi-Square analysis shows no differences among
percentages within the categories of gender and
alcohol presence. (2 = 1.034, = 1, = .309)

Research Question
Does our data of Dutchess County yield similar results
with national data and previous research? More
specifically, does the data on toxicology reports match up
to previous studies?

Materials and Methods

Data was collected from autopsies and external
examinations reported to the Dutchess County Medical
Examiners office from 2003 thru 2014. Cases were
reported based on required reporting standards and
cases labeled as suicide were examined and data
collected. Data was compiled and analyzed in SPSS
version 22.0 using Chi-square analyses and descriptive
statistics. An alpha-level of 0.05 was used for all
statistical analyses.

The data spans 11 years with 2013 having the

most victims at 46 people. Overall, approximately
89.9% of the people in the sample are White, 5.2%
are Black, and 4.9% are of other races. The youngest
victim was at the age of 14, along with four other
juvenile victims younger than 18 years old. The age
range with the most victims was the 46-65 years old
range which includes 138 victims.
Of the 326 suicide victims
308 had a toxicology test done, 15 did not and 3
cases are unknown
Of the 308 toxicology tests done
243 returned positive for toxins and 65 came
back negative
Alcohol: 100 positive and 208 negative
Prescription drugs: 172 positive and 136
negative
Illicit drugs: 45 positive and 262 negative

Chi-Square analysis shows a difference among

percentages within the categories of toxicology results
and gender. (2 = 11.417, = 1, = .001)

Discussion
The results of this study discovered that,
consistent with previous studies, approximately 33%
of the victims had alcohol in their system before death
[2,3,4]. Over all 11 years, 14% of the victims had illicit
drugs present and 55.7% had prescription drugs
present in their systems. The results also showed that
as a whole, females were more likely than males to
test positive for toxins in their system prior to death.
Research done by Connor et al. and Kaplan et al.
claim that women are less likely than men to drink
before death [4,5]. These results suggest otherwise.
We cannot claim that either men nor women are more
likely to drink before death. Research done by Conner
et. al. and Sher suggest that alcohol use predicts
more lethal means of death [4,6]. Once again, this
study shows otherwise. All four categories of method
of death had roughly 32% of the victims have alcohol
present. Therefore we cannot claim that alcohol
presence predicts a more lethal means of death.
Lastly, this study showed that compared to victims of
death by gunshot and suffocation/hanging, victims of
poisoning and other methods were more likely to test
positive for drugs in their system.

Conclusions and Future

Directions
Some key factors need to be noted in reference
to the results that may impact the outcome of this
study. First off, testing positive in a toxicology test
does not mean that the toxins found in the body are
harmful. Some of the drugs found may be necessary
daily medications that are non-addictive and non-life
threatening. Therefore, further research will include an
analysis on the types of drugs found in the victims and
how much of each is found in order to eliminate these
cases. Secondly, this study showed that death by
poison and other methods are more likely to test
positive for drugs in their system than death by
gunshot and suffocation/hanging. One thing that we
need to keep in mind is that we expect that all poison
victims had some kind of drug in their systems, as it
was the reason for their death. Lastly, further research
will be conducted to determine any significant trend
among the amount of alcohol taken and the method of
death.

References

Chi-Square analysis shows a difference among

percentages within the categories of method of death
and toxicology results. (2 = 21.789, =, < .001)

1. Centers for Disease Control and Prevention (CDC). Web-based Injury Statistics Query and Reporting
System (WISQARS) [Online]. (2013) National Center for Injury Prevention and Control, CDC
(producer).
2. Karch, D., Crosby, A., & Simon, T. (2007). Toxicology Testing and Results for Suicide Victims--13
States, 2004. JAMA: Journal Of The American Medical Association, 297(4), 355-356.
3. Sheehan, C. M., Rogers, R. G., Williams, G. I., & Boardman, J. D. (2013). Gender differences in the
presence of drugs in violent deaths. Addiction, 108(3), 547-555. doi:10.1111/j.1360-0443.2012.04098.x
4. Conner, K. R., Huguet, N., Caetano, R., Giesbrecht, N., McFarland, B. H., Nolte, K. B., & Kaplan, M. S.
(2014). Acute use of alcohol and methods of suicide in a US national sample. American Journal Of
Public Health, 104(1), 171-178. doi:10.2105/AJPH.2013.301352Nmjn
5. Kaplan, M. S., Huguet, N., McFarland, B. H., Caetano, R., Conner, K. R., Giesbrecht, N., & Nolte, K. B.
(2014). Use of alcohol before suicide in the United States. Annals Of Epidemiology, 24(8), 588-592.e12. doi:10.1016/j.annepidem.2014.05.008
6. Sher, L. (2006). Alcohol consumption and suicide. QJM 99 (1) 57-61. DOI: 10.1093/qjmed/hci146

Acknowledgments
We would like to thank Dr. Jen Bready, the Dutchess County office of
the Medical Examiner, Mount Saint Mary College and the SURE Program for
their support of this project.