TABLE 3. Toxicology results of American Indian or Alaska Native suicide decedents compared with non–American Indian or Alaska Native suicide decedents — National Violent Death Reporting System, United States, 2015–2020.
| Toxicology result | No. (%) |
Chi-square p-value† | aOR (95% CI)§ | |
|---|---|---|---|---|
| AI/AN (n = 3,397) | Non-AI/AN (n = 179,850) | |||
|
Any toxicology testing*
|
2,262 (66.6) |
109,806 (61.1) |
<0.001 |
1.2 (1.1–1.3)¶ |
|
Positive result for at least one substance**
|
1,774 (78.4) |
84,152 (76.6) |
0.046 |
1.2 (1.1–1.3)¶ |
|
Blood alcohol concentration††
| ||||
| Tested |
2,103 (61.9) |
93,124 (51.8) |
<0.001 |
1.4 (1.3–1.5)¶ |
| Positive result§§ |
1,023 (48.6) |
37,354 (40.1) |
<0.001 |
1.5 (1.4–1.7)¶ |
| Alcohol <0.08 g/dL |
169 (16.5) |
10,667 (28.6) |
<0.001 |
0.5 (0.4–0.6)¶ |
| Alcohol ≥0.08 g/dL |
821 (80.3) |
24,019 (64.3) |
<0.001 |
2.3 (2.0–2.7)¶ |
| Alcohol positive, level unknown |
33 (3.2) |
2,668 (7.1) |
<0.001 |
0.5 (0.3–0.6)¶ |
|
Opioids
| ||||
| Tested |
1,842 (54.2) |
76,672 (42.6) |
<0.001 |
1.5 (1.4–1.6)¶ |
| Positive result§§ |
228 (12.4) |
18,242 (23.8) |
<0.001 |
0.5 (0.5–0.6)¶ |
|
Benzodiazepines
| ||||
| Tested |
1,713 (50.4) |
71,192 (39.6) |
<0.001 |
1.5 (1.4–1.6)¶ |
| Positive result§§ |
190 (11.1) |
18,511 (26.0) |
<0.001 |
0.4 (0.3–0.5)¶ |
|
Cocaine
| ||||
| Tested |
1,796 (52.9) |
72,121 (40.1) |
<0.001 |
1.6 (1.5–1.7)¶ |
| Positive result§§ |
64 (3.6) |
4,940 (6.8) |
<0.001 |
0.5 (0.4–0.6)¶ |
|
Amphetamines
| ||||
| Tested |
1,841 (54.2) |
70,483 (39.2) |
<0.001 |
1.7 (1.6–1.8)¶ |
| Positive result§§ |
381 (20.7) |
9,523 (13.5) |
<0.001 |
1.5 (1.4–1.7)¶ |
|
Marijuana
| ||||
| Tested |
1,363 (40.1) |
62,684 (34.9) |
<0.001 |
1.2 (1.1–1.2)¶ |
| Positive result§§ |
491 (36.0) |
15,102 (24.1) |
<0.001 |
1.5 (1.3–1.7)¶ |
|
Antidepressants
| ||||
| Tested |
804 (23.7) |
48,972 (27.2) |
<0.001 |
0.8 (0.7–0.9)¶ |
| Positive result§§ |
203 (25.2) |
18,294 (37.4) |
<0.001 |
0.6 (0.5–0.7)¶ |
|
Antipsychotics
| ||||
| Tested |
690 (20.3) |
38,001 (21.1) |
0.248 |
0.9 (0.8–1.0) |
| Positive result§§ |
54 (7.8) |
4,336 (11.4) |
0.003 |
0.7 (0.5–0.9)¶ |
|
Barbiturates
| ||||
| Tested |
1,651 (48.6) |
59,040 (32.8) |
<0.001 |
1.8 (1.7–2.0)¶ |
| Positive result§§ |
11 (0.7) |
1,441 (2.4) |
<0.001 |
0.3 (0.2–0.6)¶ |
|
Carbon monoxide
| ||||
| Tested |
133 (3.9) |
10,333 (5.7) |
<0.001 |
0.7 (0.6–0.8)¶ |
| Positive result§§ |
41 (30.8) |
3,492 (33.8) |
0.472 |
1.0 (0.7–1.5) |
|
Anticonvulsants
| ||||
| Tested |
547 (16.1) |
38,439 (21.4) |
<0.001 |
0.7 (0.6–0.8)¶ |
| Positive result§§ |
77 (14.1) |
6,487 (16.9) |
0.082 |
0.8 (0.6–1.1) |
|
Muscle relaxants
| ||||
| Tested |
492 (14.5) |
39,311 (21.9) |
<0.001 |
0.6 (0.5–0.6)¶ |
| Positive result§§ | 34 (6.9) | 2,575 (6.6) | 0.748 | 1.1 (0.8–1.6) |
Abbreviations: AI/AN = American Indian or Alaska Native; aOR = adjusted odds ratio.
* Denominator includes all suicide decedents.
† Pearson’s chi-square test result for difference between AI/AN and non-AI/AN populations.
§ aORs measure the association between the decedent receiving a positive test result for the substance and the race of the decedent being AI/AN. The denominator was the number of decedents who were tested for each substance. Each aOR used non-AI/AN as the referent group and controlled for age group and sex.
¶ p<0.05 for aOR significance test.
** Denominator is decedents with any toxicology testing.
†† Blood alcohol concentration of ≥0.08 g/dL is higher than the legal limit in all states and the District of Columbia and is used as the standard for intoxication.
§§ Denominator for each positive result group is the number tested for the substance in that group.