Citation

Aflaki K, Ray J. CMAJ 2021; 193(17): E622.

Copyright

(Copyright © 2021, Canadian Medical Association)

DOI

10.1503/cmaj.78591

PMID

unavailable

Abstract

We thank Liu and colleagues for their article that described important temporal patterns about suicide in Canada.1 The decline observed in the age-standardized rate of suicide by poisoning leads us to wonder whether this may be because of misclassification of such suicides. This is important given concerns about rising suicidality among young and middle-aged adults, particularly during the current COVID-19 pandemic.

Accidental poisonings now mainly include illicit drug overdoses among adults, and it is at the discretion of a medical examiner or coroner to determine whether or not that death was "accidental," based on the circumstances and evidence surrounding the death.3 Deaths by firearm or suffocation (hanging) are much more likely to be deemed a suicide in the absence of any corroborating evidence (e.g., a suicide note) or an external perpetrator (i.e., evidence of a homicide). In contrast, a death by an overdose is particularly susceptible to being misclassified as an accidental poisoning, especially in the current era of opioid overuse.

Recent Canadian data have shown a resurgence in poisoning deaths because of the opioid epidemic...

Language: en