Comparison of Individual Clinical and Health Services Use Profiles Between Deaths From Unintentional Opioid and Other Drug Poisoning and Deaths From Suicide: A Quebec Linked Health Databases Study: Comparaison entre les décès par intoxications non intentionnelles dues aux opioïdes et à d’autres drogues et les décès par suicide selon les profils individuels d’utilisation des services cliniques et des services de santé : une étude de bases de données du Québec sur la santé

Objective We sought to compare unintentional opioid and other drug poisoning (OODP) and suicide deaths regarding clinical and service use profiles. Method We undertook a retrospective, administrative data-based study to identify these deaths in Quebec from 2003 to 2018. Descriptive variables were chosen among those available in the Quebec Integrated Chronic Disease Surveillance System, classified according to Anderson's model of health services as determinants of health outcomes. We also used multivariable logistic regression to compare OODP and suicide deaths. Results We identified 2,002 OODP deaths and 16,555 suicides. In both groups, a considerable proportion were male, aged 30–64 years, and pertained to materially and socially deprived areas, and most presented with at least one mental health or substance-related disorder (SRD) and used primary and specialist healthcare services in the last year before death. When comparing the two groups, some factors predominantly characterized OODP deaths (e.g., living in the Montreal area, several past-year physical comorbidities, SRDs) or suicide deaths (e.g., male sex, depression and bipolar disorder, psychiatrist visit). Similarities also emerged, including several psychiatric comorbidities (anxiety disorder, cluster B personality disorder, schizophrenia and other psychotic disorder), most past-year physical comorbidities and several factors regarding service use in the last year before death (e.g., hospitalizations and general practitioner visits/psychotherapy visits). Conclusions While some distinctions in individual clinical and service use emerged between OODP and suicide deaths, several similarities also arose, including the generally high burden of mental disorders for both populations. Suicide prevention recommendations of better detection, engagement and management of individuals with depression or SRDs at the primary care and general hospital levels, with support from coordinated mental health and addiction services, might also represent a potentially effective strategy alongside existing overdose prevention efforts and key involvement of peer-led and community-based resources to decrease OODP deaths.