Examining Substance Type and Demographics in Youth Self-Poisoning Suicide Decedents in the United States from 2017 to 2021: Contextualizing Increases in Youth Sodium Nitrite Suicides (Board#13)

Abstract : Research

Aims: Rates of sodium nitrite suicide deaths have risen in youth aged 15-24 since 2017. Sodium nitrite (NaNO2) is an odorless, colorless salt used mainly in manufacturing and as a meat preservative in the United States. NaNO2 ingestion is a particularly lethal method of suicide recommended to vulnerable youth seeking information on suicide methods in online forums. Preliminary research suggests that youth NaNO2 suicide decedents in the United States are more likely to be Asian, transgender, have an anxiety diagnosis, and have an alcohol or substance abuse problem than youth who died by all other self-poisoning methods. This poster aims to clarify these findings by comparing the demographics and precipitating circumstances of youth who died by NaNO2 ingestion to youth who died by other non-drug poison ingestion (e.g. antifreeze, CO2 inhalation, bleach). Results from this research will provide insight as to whether or not youth NaNO2 suicides follow self-poisoning trends previously reported in the literature.

Methods: National Violent Death Reporting System data for youth self-poisoning decedents aged 15 to 24 between 2017 and 2021 were coded as either drug ingestion (n = 1,196) or poison ingestion (n = 590) using ICD-10 codes and supplemental law enforcement, medical examiner, and coroner narratives. Demographics and precipitating circumstances between groups were analyzed using chi-squared tests. A binary logistic regression model was conducted to examine potential associations between self-poisoning type, race, gender, and DSM-5 diagnoses.

Results: Compared to other poison types, youth self-poisoning decedents who died by NaNO2 were more likely to be assigned female at birth (42.9% vs. 22.2%, χ2 = 26.72, p < .001), Asian (23.4% vs. 14.0%, χ2 = 7.83, p = .005), and identify as transgender (7.1% vs. 2.7%, χ2 = 6.16, p = .013). Youth who died by NaNO2 were less likely to have an alcohol use problem (1.6% vs. 5.9%, χ2 = 5.31, p = .021) than other non-drug self-poisoning decedents, and substance use was not significant. Anxiety, depression, bipolar disorder, and PTSD diagnoses were all not significant.

Conclusions: Like previous research on youth sodium nitrite suicide decedents, compared to other non-drug poison decedents, youth who died by NaNO2 were more likely to be Asian and transgender. However, youth NaNO2 decedents were less likely to have an alcohol use problem and results were insignificant for substance use, anxiety, depression, bipolar disorder, and PTSD. NaNO2 decedents were much more likely to be assigned female at birth than other poison methods, which is discordant with current literature on method lethality regarding ingestion. Further research should examine why transgender, Asian, and AFAB youth are disproportionally dying by NaNO2 to tailor suicide prevention methods to those most at risk.