Prevalence of and Factors Influencing Suicide Ideation, Attempt, and Completion in Heroin Users: A Systematic Review and Meta-Analysis

Document Type : Review Article(s)


1 Department of Counseling, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

2 School of Rehabilitation Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

3 School of Nursing and Midwifery, Nursing Care Research Center Health Management, Iran University of Medical Sciences, Tehran, Iran



Background: Suicide is considered a fundamental problem in discussions on public and global health. Thus, the current study 
aimed to review the prevalence of and reasons for successful suicide attempts in heroin users. 

Methods: This study was conducted by systematically searching the electronic databases of PubMed, Scopus, Web of Science, and 
PsycINFO from 1960/1/1 to 2021/11/1 based on the PRISMA checklist and using MeSH keywords with no temporal or linguistic 
limitations. The primary and secondary impacts of suicide were identified, and all studies following an observational design 
(cohort, case-control, and cross-sectional studies) were included in the research. Data analysis was performed using Stata version 
13. Finally, 17 studies were included in the work process for systematic review and meta-analysis.

Findings: The results showed the most frequent reasons for suicide among the studied individuals were gender (being female), 
youngness, heroin overdose, multi-drug abuse, history of repeated suicide attempts, history of psychiatric disorder (especially 
depression), joblessness, homelessness, distorted family relationships, etc. Moreover, the results of synthesizing the studies 
revealed the prevalence of suicide attempts equaled the effect size (95% CI=0.3 [0.23-0.37]) among these individuals, and the 
prevalence of successful suicides approached the effect size (95% CI=0.03 [0.01-0.05]).

Conclusion: The results of the present study showed the high prevalence of suicidal thoughts and suicide attempts among the 
heroin-abusing population. Furthermore, according to the findings, the prevalence of unsuccessful suicide attempts was ten times 
more than that of successful ones in the target population. 


Mohammad Saeed Khanjani: (Google Scholar) (PubMed)

Sayed Jalal Younesi: (Google Scholar) (PubMed)

Kianoush Abdi: (Google Scholar) (PubMed)

Marjan Mardani-Hamooleh: (Google Scholar) (PubMed)

Sajad Sohrabnejad: (Google Scholar) (PubMed)


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