Blood Alcohol Concentration in Finnish Suicide Deaths and Associated Risk Factors, 2016–2024

AIMS: There is limited research examining the relationship between blood alcohol concentration (BAC) and other risk factors among suicide deaths in Finland. Our study aimed to investigate the relationship of an elevated (more than zero) blood alcohol concentration with medical history, including sociodemographic characteristics and disease diagnoses. METHODS: Data was collected from suicide deaths in Finland from 2016 to 2024 and verified by official cause-of-death investigations, which included forensic autopsy, toxicology results, and other key information from death certificates and national healthcare registries. A condition recorded in both the death certificate (autopsy) and healthcare register was considered as confirmed diagnosis. BAC, as expressed as a percentage, was grouped into three categories: nil (BAC = 0.000), low-to-medium (BAC = 0.010%-0.099%), and high (BAC = 0.100%-0.500%). Descriptive statistics, correlation, and stepwise logistic regression to estimate odds ratios (ORs) for BAC categories were undertaken. RESULTS: The number of suicide deaths from 2016 to 2024 in Finland was n = 6892, with 5183 men (75.2%) and 1709 women (24.8%). BAC reports were available for n = 6835. Independent factors associated with a low-to-medium or high BAC at death were alcohol use (ORs: 41.80-275.27), longer than 1 day since last healthcare visit (ORs: 1.54-2.53), previous suicide attempt(s) (ORs: 1.42-1.65), and female gender (only for high BAC, OR: 1.30). There were reduced odds for schizophrenia spectrum diagnosis (OR: 0.17), bipolar disorder (OR: 0.29), age groups 10-19 (ORs: 0.30-0.65), 80 and over (ORs: 0.15-0.39), and 70-79 years (only for high BAC, OR: 0.43). CONCLUSION: Our findings show that individuals with documented habitual alcohol use, female gender, previous suicide attempts, and less frequent healthcare visits had higher odds of intoxication at suicide. Meanwhile, being aged under 20, over 70, or diagnosed with schizophrenia or bipolar disorders reduced the odds. The results highlight the need for proactive healthcare engagement and integrated alcohol-use interventions in suicide prevention strategies.