Modern technology and suicide

Initially, it did not sound like anything unusual. Another patient had tried to commit suicide. The unfortunate combination of an exacerbated depression and loneliness around the holidays and the availability of prescription medications, lead this unfortunate patient to try to end his life. He took multiple tablets of Vicodin (pain killer with opioid analgesic and Tylenol) and Clonazepam (sedative, anxiety medication).

What was unusual about this case is that the patient had, actually, sent his girlfriend a text message with his intentions to commit suicide. His girlfriend acted very promptly and contacted the police.

He was found at home laying in bed. The patient was unresponsive and had shallow breathing. A breathing tube was placed by the paramedic. In the emergency Department the patient was noted to have a very high Tylenol level indicating a massive overdose. The appropriate antidote medication was started immediately. He was discharged three days later with no evidence of any significant liver toxicity.

This case demonstrates yet another example of how modern technology changes all aspects of our lives. Had this patient not texted his girlfriend about his intentions, he most likely would have been dead. Texting has become so ubiquitous that there is even a concern of driving while texting. Just talking on a cell phone in a car is distractive enough; I cannot image how people can text at the same time.

With a rapid spread of other technology including social media like Twitter and Facebook, I will not be surprised that there will be more changes on how we do things in our lives, or death if you will.

It always strikes me how many young patients I admit to the hospital with a suicide attempt or overdose. Most of my patients come with drug overdose (opioids and benzodiazepines being the most common) and occasionally I see a self inflicted gun shot wound (see image above). Most of these patients do Ok and eventually discharged. What surprises me is how different my personal experience from the official statistics. According to the National Institute of Mental Health most suicide methods in male are by firearms (56%), second being suffocation (23%) and poisoning (most commonly seen in my practice) is only in 13%. The statistics is quite different for the female population with poisoning being most common (40%). Still, this is very different from what I see in my practice. Reviewing suicide statistics by state, age etc did not explain this discrepancy. One likely explanation is that the “success” rate being different for any given suicide method and thus the difference.