Medications without a patient: Potential lethal implications of pharmaceuticals left behind

Background: Little has been published on the sources of medications used in suicide by self-poisoning. Aims: To examine data on self-poisoning occurring through the use of medications returned to the next of kin after the death of a family member or friend ("returned medication") and to examine public policies relevant to this issue. Method: A review of charts at the Office of the Chief Coroner of Ontario for deaths by self-poisoning suicide in the City of Toronto occurring between 1998 and 2010 was conducted. Information regarding the source of medication used in self-poisoning was extracted. Federal, provincial, and local policies were also examined to determine whether there are guidelines governing returning medication to next of kin. Results: Of 567 suicide deaths by self-poisoning in Toronto over 13 years, there were eight cases in which returned medication was used in suicide by self-poisoning. No policies prohibiting this type of medication return were identified. Conclusion: Suicide by self-poisoning using returned medications is an important consideration that may not yet be fully appreciated, and has relevance for suicide prevention policies.