Suicide Among Aboriginal People in Canada - Institut universitaire ...

Chapter 3gesture in a somewhat calculated or manipulative way (Dingman and McGlashan, 1988). However, onecannot dismiss the risk of suicide in patients with personality disorders as they are much more likely to dieby suicide compared to the general population (Paris, Brown, and Nowlis, 1987; Tanney, 1992).Alcohol and Substance UseThe main reason why suicides happen is alcohol and drugs … But I’m the kind of personthat likes to help and I get frustrated sometimes too. Like for instance I get upset at parents.I guess we all grew up in different ways and I get so angry at especially the alcohol and drugsthat are going on in our community … when a person is sober, they’re so different … yousee all the goodness in them. You know they have that potential, they have that wisdom ...But when they’re drinking and when they’re in these prescription drugs, they’re so different.I got a friend, she’s a real good parent, she’s a real good person to talk to. She loves the kids,but when she’s drinking … she’s so different and I tend to back away from her … because ofthat alcohol, that’s the — for me, I don’t like that alcohol (First Nation adult).The consumption of alcohol and other intoxicating substances is often a contributing factor to suicide forseveral reasons. Alcohol and other central nervous system depressants can reduce inhibitions, increaseimpulsivity, and intensify negative emotions (e.g. sadness, depression, anger, and anxiety). They may alsodecrease a person’s fear of death and an ability to imagine the consequences of their actions. Taken togetherwith other drugs, alcohol can increase the lethality of over-the-counter and prescription medications ordrugs that are often used as instruments of suicide. On occasion, people who have been drinking withoutserious suicidal intent may impulsively attempt suicide while intoxicated. The frequency and amount ofalcohol consumption is also a factor. In a representative sample in the United States, it was found thatheavy alcohol drinkers were more likely to die by suicide than those who were light or moderate drinkers(OR=1.64; 95% CI=1.16–2.33) (Kung et al., 1998).The use of other substances may also be associated with suicide risk or contribute to suicidality. A study ofhigh school students in Texas showed that alcohol, marijuana, cocaine, and steroids were associated withan increased risk of attempted suicide among different ethnic and gender subpopulations (Grunbaum,Basen-Enquist, and Pandey, 1998). In addition to their direct effects on mood and behaviour, alcoholand substance use may also be an indication of pre-existing psychological distress and social problemsthat contribute to suicidal behaviour.Alcohol intoxication has been noted to be a major factor contributing to suicide in most studies ofAboriginal people, including: the Cree of northern Ontario (Ward and Fox, 1977); the Ojibwe of northernOntario and Manitoba (Spaulding, 1986; Thompson, 1987); the Inuit of Greenland, Alaska, and theNorthwest Territories (Aoun and Gregory, 1998; Isaacs et al., 1998; Kettl and Bixler, 1991; Kraus, 1972;Rodgers, 1982; Sampath, 1992; Thorslund, 1990); and numerous studies of American Indian groups inthe United States (Brod, 1975; Group for the Advancement of Psychiatry, 1989). A case-control studyon Alaska Natives who died by suicide between 1980 and 1984 found that approximately half of themhad a documented history of alcohol abuse in their medical records, which was significantly more thanthe control group (Kettl and Bixler, 1993). In the Alaskan study conducted by Gregory (1994) of allknown patients of Eskimo 5 ethnic origin who attempted suicide in the region over a 6-month period in1993, 57 per cent of the suicide attempts were preceded by alcohol consumption. Over the period from1980 to 1998 in New Mexico, alcohol was implicated in two-thirds (69%) of deaths by suicide among38