Factors associated with cocaine use among individuals who died by suicide in the Federal District, Brazil

Introduction: Suicide, a leading cause of death among young people and adults, has been increasing worldwide and is closely associated with substance use. Objective: To identify the factors associated with cocaine use in individuals who died by suicide between 2009 and 2019 in the Federal District, Brazil. Methods: This was a cross-sectional study of 1,161 individuals who died by suicide, with data sourced from the Mortality Information System, the Notifiable Diseases Information System (SINAN), and Civil Police records. We estimated crude and age- and sex-adjusted prevalence ratios (PR). Results: The 19–39 age group (PR: 5.2; 95% CI 2.0–13.6), Black or Brown race/skin color (PR: 1.8; 95% CI 1.3–2.5), male sex (PR: 2.9; 95% CI 1.8–4.8), fewer than 8 years of education (PR: 1.5; 95% CI 1.1–1.9), a criminal record (PR: 2.6; 95% CI 1.9–3.5), a history of being a victim of crime (PR: 1.3; 95% CI 1.0–1.8), and a positive toxicology screen for ethanol (PR: 2.9; 95% CI 2.2–3.7) and cannabis (PR: 3.0; 95% CI 2.2–4.0) were among the factors associated with cocaine use. In the adjusted analysis, race/skin color, educational level, criminal record, positive toxicology screens for ethanol and cannabis, and causes of suicide remained associated with the outcome. Conclusion: Social vulnerabilities, a criminal record, and polysubstance use increase the likelihood of cocaine use among individuals who died by suicide. Recognizing these factors can guide targeted interventions and prevention policies aimed at reducing these preventable deaths.