Overdose Deaths in Young Substance Abusers: Accidents or Hidden Suicides?

91% of 1969 adolescent psychiatric inpatients were traced after a mean follow-up period of 15 years. 39 patients had died from drug overdoses. Comparing these 39 cases with 39 surviving controls & 35 suicides from the same patient population, it was found that the suicide cases had more psychotic symptoms, suicidal ideation, learning difficulties, & somatic disorders. The suicide cases received less follow-up treatment on discharge from hospital, did not enter specific drug treatment programs, & were the only ones to be discharged to the street. There were no significant differences between the overdose cases & surviving controls. Both groups showed poor impulse control & risk-taking behaviour more often than the suicide group lending support to the hypothesis that the majority of overdose deaths in young drug addicts are accidental poisonings & not misclassified suicides. (35 refs.)