Suicide Attempts Using Poison Have Surged Among Young People

More young people than ever are trying to kill themselves using poison. The rate of attempted suicide by poison has more than doubled among people under 19 in the past decade in the United States and more than tripled for girls and young women 10 to 24.

The new numbers, published Wednesday in the Journal of Pediatrics, come amid an overall rise in suicides nationwide across age groups and gender. But the sudden and sharp rise in poison-related suicide attempts by children and teens has left researchers and health advocates searching for answers.

"There's something very alarming happening here," said Henry Spiller, director of the Central Ohio Poison Center and co-author of the study. "Even if we don't know why it's happening, it's a major signal that there are big problems in children's lives right now and we as a society need to address them."

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Suicide is the 10th-most-common cause of death in the United States and the second-most-common among teenagers and young adults.

Drawing on 19 years of data from 55 poison centers across the country, researchers found that among people 10 to 15, attempted suicides by poison were relatively flat until 2010.

From 2011 to 2018, however, the numbers began to skyrocket, increasing by 141 percent overall. The occurrence among girls was particular pronounced. Among girls 10 to 12, for example, the poison-suicide attempts increased by 338 percent.

Of the 1.6 million suicide attempts by youths examined in the study, more than 1.1 million, or 71 percent, were by girls.

Part of that can be attributed to differences in the methods people use to kill themselves that hold true from adolescents to adults.

Boys and men are more likely to employ violent means such as guns and suffocation. Girls and women are more likely than males to ingest pills or other forms of poison.

The data shows that the rate at which poison-related suicide attempts have resulted in serious injuries or deaths has also increased among young people.

"The numbers are troubling, and it confirms a lot of current concerns about suicide drifting into younger ages," said Christine Moutier, who is chief medical officer for the American Foundation for Suicide Prevention and was not involved in the study.

Spiller said he is working on a follow-up study that focuses on what poisonous substances are being used most by young people. So far, he said, "it looks like a wide variety, basically what's in the home: Tylenol, antihistamines, their parents' pills, medication for ADHD, anti-depressants."

Spiller said he and others have overlaid their findings with other data to try to identify why the rates have spiked so sharply since 2011. They studied data from the rise of opioid addiction and deaths in recent years, thinking that the sharp increase could be due to increased access to drugs or fallout from parents' deaths or addictions. But the timing did not fit precisely - the beginnings of the opioid epidemic traces back years before the 2011 spike.

They also compared it against economic data, but much of the country's downturn occurred in 2008 or 2009.

"Unfortunately, we can't definitely answer the why. That's not how the data works," said John Ackerman, a co-author and clinical psychologist at Nationwide Children's Hospital in Columbus, Ohio.

Ackerman and Spiller, however, suspect the sudden increase in recent years has to do with the advent of smartphones and how they have made social media much more pervasive in young people's lives.

The iPhone 3 came out in 2008, Spiller notes, and the Android phones had come into widespread use by 2011. Adults adopted such devices first, but within a year or two, such smartphones became more common among adolescents.

For years now, across all demographic groups, the death rate from suicide has been rising broadly. Experts cannot easily explain it. There is no single factor driving the phenomenon.

Studies have shown suicidal thoughts among teenagers ages 18 or 19 have increased 46 percent from 2008 to 2017, and suicide attempts among people 22 to 23 have doubled.

"It's not going to be any one thing that explains these troubling trends," Moutier said. "And the impact of social media on youth mental health is complex, but the research we've seen so far suggests heavy screen time does have an impact on mood, sleep and suicide risk."

Ackerman at Nationwide Children's Hospital has been working with 125 middle and high schools in Ohio to help them develop stronger suicide prevention programs.

"There are things we know work, but we haven't even scratched the surface on implementing them," he said. For example, he said, universal screening for suicide - simply asking all students a handful of questions, including whether they have had suicidal thoughts - has shown to be effective at identifying those most at risk.

But few schools have such screening programs in place, child advocates say, and there is a shortage of funding, resources and training for suicide prevention in most school systems.

Another obstacle Ackerman said he often sees among parents and school officials in tackling the rising problem of youth suicides is embarrassment, shame or simply fear they won't know what to say or do.

"There's this myth that if you talk about suicide you will put it in their minds," he said. "But that doesn't solve the problem. You actually reduce the risk when you have a plan for helping kids through these difficult feelings."