Characteristics and circumstances of cocaine-related completed suicide in Australia, 2000-2021

Background: There has been a substantial global increase in cocaine use and associated harms. The current study aimed to: 1. Determine the case characteristics and circumstances of death of cocaine-related suicide in Australia 2000-2021; and 2. Determine the toxicological profiles of cases.Methods: Retrospective study of cocaine-related death in Australia, 2000-2021, retrieved from the National Coronial Information System (NCIS). Suicide intent was based upon the NCIS code for Intentional Self-harm, derived from case circumstances and coroners' conclusions. Sex comparisons were made for all major variables.Results: A total of 157 cases were identified, 82.2% male, 79.5% employed, with a mean age of 32.3 years. Concerns for mental health were documented in 65.6%, a previous suicide attempt in 21.0%, a history of sub-stance use treatment and/or negative consequences of substance use in 45.9% and injecting drug use in 14.6%. Manner of death amongst both sexes was predominantly by physical means (82.8%). Written intent was docu-mented in 29.3%. Intense agitation prior to the incident was noted in 28.0% and conflict in 24.8%. The median blood cocaine concentration was 0.060 mg/L (range 0.007-5.500). Other drugs were present in 95.5%, most commonly alcohol (63.1%) with a median concentration of 0.140 g/100 ml. Psychostimulants other than cocaine were present in 31.2%.Conclusions: The 'typical' cocaine-related suicide case was a male, aged in their early thirties, who was highly likely to be employed. The majority of cases used physical means, and a substantial minority were highly agitated and engaged in conflict prior to the fatal incident.

Automated summary

This study investigated the characteristics and circumstances of cocaine-related suicide cases in Australia from 2000 to 2021, as well as the toxicological profiles of these cases. The findings revealed that the typical cocaine-related suicide case was a male in his early thirties, with a majority of cases using physical means for suicide and a significant number exhibiting intense agitation and conflict prior to the fatal incident.