San Diego, CA—Suicide is a higher risk for pharmacists than others their age, and job-related problems clearly play a role, according to a new study.
Previous to this research, little had been known about suicides among pharmacists, according to the University of California San Diego–led investigation.
Their report in the Journal of the American Pharmacists Association pointed out that common means of suicide among pharmacists were by firearms, poisoning, and hanging/strangulation/suffocation.
"Removal of lethal means, proactive suicide screening, and crisis support are necessary actions," researchers suggested. "Encouraging help-seeking behaviors to identify and treat pharmacist depression is warranted. Future research is needed to determine the nature of job-related problems to develop mitigation strategies for suicide. Future analysis of pharmacist suicides compared with other health care professionals would also be insightful."
Background information in the study advises that suicide is one of the leading causes of death worldwide, and estimates of suicide among health professionals are higher than the general population. The study sought to quantify the incidence, means, and characteristics of pharmacist suicides in the United States.
To accomplish that, researchers obtained data from the CDC's National Violent Death Reporting System (NVDRS) for the years 2003 to 2018. That dataset contained all suicides—coded by occupation—reported by medical examiners and law enforcement from 39 states, Washington, D.C., and Puerto Rico. Researchers then compared suicide characteristics between pharmacists and nonpharmacists.
The study noted that from 2003 to 2018, the NVDRS contained 316 pharmacist suicides compared with 213,146 nonpharmacist suicides. Researchers calculated the age-adjusted rates per 100,000 people as 19.6, 20.1, and 18.2 for 2004, 2009, and 2014, respectively.
"The most common means of suicide was firearm," the researchers wrote. "Associated factors for suicide included job problems, current mental illness treatment, and suicide note."
While not much is known about pharmacist suicide, the authors cite two studies outside of the U.S.—one in New Zealand where mortality ratios were elevated for female pharmacists and both male and female nurses, and another in Denmark, where suicides among medical and related occupational groups, pharmacists, nurses, and physicians were elevated compared with teachers.
"In both New Zealand and Denmark, pharmacologic poisoning was the most common means for suicide," researchers stated. "Pharmacists are among the most visible and accessible front-line health workers in the community, but suicide data among pharmacists in the United States have not been published to date. Previous studies on nurses and physicians suggest that pharmacists may also be at higher risk. Increasing awareness and knowledge of suicides among pharmacists are the first steps to developing interventions to prevent this potential tragedy."
Of the 316 pharmacists who died by suicide during the study period, 75% were men and 85% were white. Those taking their own lives had a mean age of 53.5 (SD = 15.7) years, compared with 49.0 (SD = 16.7) for nonpharmacists (P <.001). While the most common means of suicide was firearms (49.8%), the second-most common was poisoning (79, 29.4%).
"Compared with non-pharmacists, the use of firearms was similar to non-pharmacists (49.8% vs. 51.0%, P >.999) but poisoning was more common among pharmacists (29.4% vs. 16.7%, P <.001), and hanging, strangulation, or suffocation was more common among non-pharmacists (13.0% vs. 24.5%, P = .007)," the authors wrote, adding, "The most common substances implicated in those who died by poisoning were opioids, benzodiazepines, antidepressants, and alcohol."
The study also compared male and female pharmacists, noting that men were more likely to have a physical health problem associated with the suicide (OR 2.81 [OR range: 1.28-6.19], P = .238), although that was not statistically significant.
According to the authors, male pharmacists were significantly less likely to have a history of suicide attempts (OR 0.34 [OR range: 0.18-0.62], P = .018) compared with female pharmacists and less likely to have a recorded mental health problem, current mental illness treatment, history of mental illness treatment, history of suicide thoughts, or recent suicide of family or friend. The authors added that those differences were not statistically significant.
"When comparing pharmacists and non-pharmacists, job problems were the most significant features associated with suicide (OR 1.77 [OR range: 1.32-2.37], P = .011)," researchers note. "Other significant associations among pharmacists compared with non-pharmacists were current mental illness treatment (P = .008) and suicide note (P = .009)."
The content contained in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.
