Title : Epidemiology of chemical poisoning with suicidal intent in Colombia: A public health issue 2012-2023
Abstract:
Objective: To analyze the possible social, environmental, and demographic factors associated with chemical poisoning with suicidal intent in Colombia during the period 2012-2023.
Methodology: Ecological, retrospective, quantitative study based on records from the Public Health Surveillance System (SIVIGILA) of the National Institute of Health (INS). All reported cases of poisoning with suicidal intent were included, classified by chemical substances such as medications, pesticides, other chemicals, psychoactive substances, solvents, gases, methanol, and metals. Sociodemographic variables were analysing sex and life cycle; environmental variables: region and department of occurrence; and epidemiological variables: type of substance, cases, and deaths. The information was cleaned and systematized in Microsoft Excel, and an inference was made using Joinpoint software to see the trend in the chemical most used for poisoning.
Results: Between 2012 and 2023, 205,089 cases of chemical poisoning with suicidal intent were reported in Colombia, of which 1,606 were completed suicides. Women accounted for 67.45% of cases, with an incidence of 46.31 per 100,000, compared to 23.35 in men (p < 0.05). Medications were the most used substances, followed by pesticides. Acetaminophen was the most used medication in both sexes, while amitriptyline and tramadol caused deaths. Among pesticides, the commercial poison called Campeón was the most used, but Paraquat and Furadan predominated in deaths. Regarding the life cycle, drug poisoning was concentrated in adolescence, but deaths occurred in adults. In the case of pesticides, cases and deaths were concentrated in adulthood. In terms of regions, the Andean region had the highest incidence, with the department of Antioquia standing out. In the Caribbean region, Atlántico stood out; in the Pacific region, Valle del Cauca; in the Orinoquia region, Meta; and in the Amazon region, Putumayo. The trend of intentional suicide by medication poisoning was on the rise during the study period.
Discussion: Adolescent women present higher rates of self-poisoning with medications, which is associated with the higher prevalence of depression and self-medication in this group. In contrast, men more frequently used pesticides, which are linked to completed suicides due to their high lethality and easy access in rural areas. The availability of pesticides in agricultural departments such as Antioquia, Valle del Cauca, and Atlántico, as well as in territories with illicit crops or armed conflict (Putumayo, Meta), reinforces the role of environmental and socioeconomic factors in these events. In addition, extreme poverty, unemployment, and mental health limitations exacerbate vulnerability in rural and peasant communities.
Conclusion: Chemical poisoning with suicidal intent is a serious public health problem in Colombia, with a marked influence of social, economic, and environmental factors. It is recommended to strengthen mental health policies, control access to pesticides and over-the-counter medications, as well as epidemiological surveillance and suicide prevention strategies in the territories with the highest incidence.
