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Abstract：
OBJECTIVE: Research regarding the contribution of specific psychoactive substances to suicidality has yielded equivocal results. The present study examined the prevalence and factors associated with suicidal thoughts and behaviors among a population-based sample of untreated illicit substance users.
METHODS: A total of 616 illicit substance users who were recruited from high-risk areas of Shiraz using snowball sampling participated in the study. Eligible participants were individuals aged 18 years and older who regularly used one illicit psychoactive substance (e.g., opioids, heroin, cannabinoids, stimulants, hallucinogens) for at least one year and who had received no treatment for their drug use during the past year. Data were collected regarding socio-demographic characteristics, mental history, and substance use habits. Data regarding suicidal thoughts and behaviors were assessed using the Beck Suicidal Ideation Scale (BSIS) and self-reports of previous suicide attempts. Multiple logistic regression analysis was used to identify independent variables associated with suicidality.
RESULTS: Among the participants, 23.6% reported having had suicidal thoughts during the past week and 6.7% reported having attempted suicide during the past year. Methamphetamine was reported as the primary substance of use among approximately half of the participants who attempted suicide during past year (49.2%). Multiple logistic regression analysis showed that current suicidal thoughts were independently associated with having no job, a history of mental health condition, previous suicidal attempts, concurrent use of more than one substance, and using methamphetamine and heroin as the primary substances. Suicidal thoughts were not associated with increased odds of regular opium and cannabis use.
CONCLUSIONS: Both methamphetamine and heroin use are significantly associated with current suicidal thoughts. Evaluation of the risk of suicidality by physicians and mental health care professionals in both community and outpatient settings would be especially appropriate among those individuals using these psychoactive substances.
METHODS: A total of 616 illicit substance users who were recruited from high-risk areas of Shiraz using snowball sampling participated in the study. Eligible participants were individuals aged 18 years and older who regularly used one illicit psychoactive substance (e.g., opioids, heroin, cannabinoids, stimulants, hallucinogens) for at least one year and who had received no treatment for their drug use during the past year. Data were collected regarding socio-demographic characteristics, mental history, and substance use habits. Data regarding suicidal thoughts and behaviors were assessed using the Beck Suicidal Ideation Scale (BSIS) and self-reports of previous suicide attempts. Multiple logistic regression analysis was used to identify independent variables associated with suicidality.
RESULTS: Among the participants, 23.6% reported having had suicidal thoughts during the past week and 6.7% reported having attempted suicide during the past year. Methamphetamine was reported as the primary substance of use among approximately half of the participants who attempted suicide during past year (49.2%). Multiple logistic regression analysis showed that current suicidal thoughts were independently associated with having no job, a history of mental health condition, previous suicidal attempts, concurrent use of more than one substance, and using methamphetamine and heroin as the primary substances. Suicidal thoughts were not associated with increased odds of regular opium and cannabis use.
CONCLUSIONS: Both methamphetamine and heroin use are significantly associated with current suicidal thoughts. Evaluation of the risk of suicidality by physicians and mental health care professionals in both community and outpatient settings would be especially appropriate among those individuals using these psychoactive substances.
摘要：
目的：关于特定精神活性物质对自杀的贡献的研究产生了模棱两可的结果。本研究调查了未经治疗的非法药物使用者的人群样本中与自杀念头和行为相关的患病率和因素。
方法：从设拉子高风险地区招募的616名非法药物使用者使用滚雪球取样参与了这项研究。符合条件的参与者是年龄在18岁及以上的人，他们经常使用一种非法精神活性物质(例如，阿片类药物,海洛因,大麻素,兴奋剂,致幻剂）至少一年，并且在过去一年中未接受药物治疗。收集了有关社会人口学特征的数据，精神病史,和物质使用习惯。使用贝克自杀意念量表（BSIS）和先前自杀未遂的自我报告评估了有关自杀意念和行为的数据。多元逻辑回归分析用于确定与自杀相关的独立变量。
结果：在参与者中，23.6%的人报告在过去一周有自杀念头，6.7%的人报告在过去一年有自杀企图。据报道，在过去一年中企图自杀的参与者中，大约有一半（49.2％）是主要使用甲基苯丙胺的药物。多因素logistic回归分析显示，当前自杀念头与无工作独立相关，有精神健康病史,以前的自杀企图,同时使用一种以上的物质，使用甲基苯丙胺和海洛因作为主要物质。自杀念头与经常使用鸦片和大麻的可能性增加无关。
结论：甲基苯丙胺和海洛因的使用与当前的自杀念头显著相关。在社区和门诊环境中，医生和精神卫生保健专业人员对自杀风险的评估对于使用这些精神活性物质的个体尤其合适。
方法：从设拉子高风险地区招募的616名非法药物使用者使用滚雪球取样参与了这项研究。符合条件的参与者是年龄在18岁及以上的人，他们经常使用一种非法精神活性物质(例如，阿片类药物,海洛因,大麻素,兴奋剂,致幻剂）至少一年，并且在过去一年中未接受药物治疗。收集了有关社会人口学特征的数据，精神病史,和物质使用习惯。使用贝克自杀意念量表（BSIS）和先前自杀未遂的自我报告评估了有关自杀意念和行为的数据。多元逻辑回归分析用于确定与自杀相关的独立变量。
结果：在参与者中，23.6%的人报告在过去一周有自杀念头，6.7%的人报告在过去一年有自杀企图。据报道，在过去一年中企图自杀的参与者中，大约有一半（49.2％）是主要使用甲基苯丙胺的药物。多因素logistic回归分析显示，当前自杀念头与无工作独立相关，有精神健康病史,以前的自杀企图,同时使用一种以上的物质，使用甲基苯丙胺和海洛因作为主要物质。自杀念头与经常使用鸦片和大麻的可能性增加无关。
结论：甲基苯丙胺和海洛因的使用与当前的自杀念头显著相关。在社区和门诊环境中，医生和精神卫生保健专业人员对自杀风险的评估对于使用这些精神活性物质的个体尤其合适。
