LAUSR

BACKGROUND AND AIMS In the United States (US), up until 2018, both the prevalence of heavy alcohol use and the suicide mortality rate increased among men and women; however, women had experienced a notably higher increase in both. Since heavy alcohol use may have contributed to the observed sex disparity in the suicide mortality rate increase, the aim of the current study was to estimate the temporal trend of the sex- and age group-specific proportion of suicides that were alcohol-involved in the US. DESIGN Using restricted-access data from the National Violent Death Reporting System, we performed joinpoint regression analyses to investigate temporal trends in the sex- and age-group (young adults: 18-34 years; middle-aged adults: 35-64 years; and older adults: 65+ years) specific proportion of suicides that were alcohol-involved. SETTING United States. PARTICIPANTS A total of 115,193 suicide decedents 18+ years of age from 2003 to 2018. MEASUREMENTS The sex- and age-group specific proportion of suicides that were alcohol-involved, among all suicide decedent, for which the decedent had a blood alcohol concentration (BAC) a) ≥0.04 g/dl and b) ≥0.08 g/dl. FINDINGS For 2003-18, the proportion of suicides that were alcohol-involved wherein the decedent had a BAC ≥0.08 g/dl significantly increased on average annually for women of all age groups (young women: 2.80% [95% confidence interval [CI]: 1.86%, 3.75%]; middle-aged women: 2.20% [95% CI: 1.20%, 3.21%]; older women: 10.48% [95% CI: 1.17%, 20.65%]), while only middle-aged men experienced a significant average annual percent increase (0.81% [95% CI: 0.003%, 1.62%]). CONCLUSION In the United States between 2003 and 2018, alcohol use preceding death by suicide increased among women compared with men.