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The role of alcohol use in pesticide suicide and self-harm: a scoping review

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posted on 2024-02-08, 06:13 authored by L Schölin, Kylie LeeKylie Lee, L London, M Pearson, F Otieno, M Weerasinghe, F Konradsen, M Eddleston, JB Sørensen
Purpose: Suicide and self-harm by pesticide self-poisoning is common in low- and middle-income countries (LMICs). Alcohol is an important risk factor for self-harm; however, little is known about its role in pesticide self-poisoning. This scoping review explores the role that alcohol plays in pesticide self-harm and suicide. Methods: The review followed the Joanna Briggs Institute scoping review guidance. Searches were undertaken in 14 databases, Google Scholar, and relevant websites. Articles were included if they focussed on pesticide self-harm and/or suicide and involvement of alcohol. Results: Following screening of 1281 articles, 52 were included. Almost half were case reports (n = 24) and 16 focussed on Sri Lanka. Just over half described the acute impact of alcohol (n = 286), followed by acute and chronic alcohol use (n = 9), chronic use, (n = 4,) and only two articles addressed harm to others. One systematic review/meta-analysis showed increased risk of intubation and death in patients with co-ingested alcohol and pesticides. Most individuals who consumed alcohol before self-harming with pesticides were men, but alcohol use among this group also led to pesticide self-harm among family members. Individual interventions were recognised as reducing or moderating alcohol use, but no study discussed population-level alcohol interventions as a strategy for pesticide suicide and self-harm prevention. Conclusion: Research on alcohol’s role in pesticide self-harm and suicide is limited. Future studies are needed to: further assess the toxicological effects of combined alcohol and pesticide ingestion, explore harm to others from alcohol including pesticide self-harm, and to integrate efforts to prevent harmful alcohol use and self-harm.


LS, MP, JBS, and MW are supported by the Centre for Pesticide Suicide Prevention. The Centre for Pesticide Suicide Prevention is funded by a grant from Open Philanthropy, at the recommendation of GiveWell. KL is supported by the Australian National Health and Medical Research Council via an Ideas Grant (APP1183744).


Publication Date



Social Psychiatry and Psychiatric Epidemiology: the international journal for research in social and genetic epidemiology and mental health services






22p. (p. 211-232)


Springer Nature



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