Suicide by a Novel Toxic Substance: A Scoping Review

OBJECTIVE: A growing international concern has emerged regarding a novel suicide method involving the ingestion of a toxic substance, particularly after the arrest of Kenneth Law. Better surveillance and understanding of the profiles of individuals who adopt the method are critical to improving the effectiveness of suicide prevention efforts. This review aims to summarize the existing epidemiological evidence on suicide attempts and deaths by self-poisoning with the substance. METHODS: This study followed Guidance for Conducting Systematic Scoping Reviews, and the searching process was in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - Scoping Reviews (PRISMA-ScR). A literature search was conducted in MEDLINE, EMBASE and SCOPUS for articles published until March 16, 2026, using the search terms related to this substance AND (suicid* OR 'suicide attempt' OR 'self-harm' OR 'self-poisoning' OR 'intentional' OR 'deliberate'). Case reports, case series, and research articles reporting suicide attempts or deaths involving the substance were included. RESULTS: A total of 67 studies were included in the review, the majority of which were case reports or case series. Several cases reported that individuals learned about and/or purchased the substance online. CONCLUSIONS: A rising trend in suicide involving this substance has been observed globally. The findings support a targeted, evidence-based public health response that addresses the online supply chain directly, improves the accuracy of surveillance and coding, equips clinicians and investigators with the awareness needed to identify cases, and coordinates regulatory action across jurisdictions in restricting its access.