Many U.S. suicide deaths may be recorded as accidents or deaths of undetermined intent, particularly in drug overdose cases, according to a new public health commentary involving UR Medicine experts.
The researchers said the national suicide rate in 2024 was nearly 38% higher than in 2000, while deaths from opioid and other drug poisoning more than tripled. Over the same period, the recorded suicide rate from drug poisoning rose from 1.3 to 1.8 deaths per 100,000 people.
Ian Rockett, an injury epidemiologist and adjunct psychiatry professor at UR Medicine, estimated that as many as 30% of overdose deaths classified as accidental or undetermined could be suicides. Determining intent after a drug death can be difficult without evidence such as a note, documented psychiatric history or record of previous attempts, the commentary said.
The exact increase in the national suicide rate between 2000 and 2024 was 37.5%, according to the commentary.
Rockett proposed broader use of a measure called self-injury mortality, which combines registered suicides with most deaths involving drug self-intoxication. The approach focuses on behavior before death instead of requiring officials to determine intent after death.
Eric Caine, a UR Medicine professor emeritus of psychiatry and co-founder of the Center for the Study and Prevention of Suicide, said more accurate measurement is necessary to understand the scale of the problem and evaluate prevention programs.
The commentary also cited limited resources and inconsistent training in medical examiner and coroner offices as factors that can lead to misclassification. Its authors called for improvements in how deaths are examined and recorded.
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