Suicide, the taking of one' s own life, while currently the nation' s eleventh leading cause of death—with violent death among the 8-24-year-olds, as Table 1.2 informs us—i t is the the third leading terminator of life, but slips into second place for the 25-34-year-olds In 2003, 31,484 young lives were snuffed out across the country: 25,203 young men and 6281 young women [13]. Adding these traumatic deaths to the highway deaths, we are looking at some 75,000 deaths annually. Although it is not treated that way, because trauma is not a rubric, a recognized category, trauma is one of the most notorious problems the country must deal with, but doesn't. It is as if it doesn't exist, as it is seen as two separate issues, when it should be seen and dealt with as a single substantive issue. Until it is, expect the numbers to increase. The number of potentially productive years of life lost should give us pause: 1,100,000 years of life lost to suicide. Add another 2 million for motor vehicle deaths. From a purely economic concern, can the country afford the loss of 3 million potentially productive days annually? It's a no-brainer.

According to the American Association of Suicidology (AAS), suicide is, beyond doubt, preventable. Most suicidal individuals, the AAS tells us, want to live but are simply unable to recognize alternatives. Most offer clues, warning signs, but parents, friends, teachers, and physicians fail to read them. With that type of illiteracy, a suicide occurs every 16.7 minutes. Although 31,000 do commit suicide, according to the AAS there are 787,000 attempts: 25 attempts for every death, with an average 3 : 1 female : male ratio for every attempt. I suspect we would agree that this is an intolerable form of illiteracy. But how do we become literate?

Suicide Rates for Ages 65 to 85+

Age Group

Figure 1.1. Comparison of suicide rates for men and women ages 65-85+. (Source: Centers for Disease Control, 2002.)

Age Group

Figure 1.1. Comparison of suicide rates for men and women ages 65-85+. (Source: Centers for Disease Control, 2002.)

Surprisingly, winter is not the season of greatest discontent; spring exacts the greatest toll—just the opposite of what I would have imagined. For most of us spring is the season of rebirth and new beginnings, and winter is perceived as cold, damp, and depressing.

At the opposite end of the age spectrum, the elderly, 65 and over, make up 12.4% of the country 's total population, yet account for almost 18% of all suicides. According to the AAS, an elderly suicide occurs every 95 minutes. Elderly white men are the highest at-risk group, with some 35 suicides per 100,000. Figure 1.1, shows the rising rates with age and the difference between men and women. Although older adults attempt suicide less often than do others, they have a higher successful completion rate. If all attempts were successful, we would be looking at a 0.75 million suicide deaths a year, which would far exceed the combined death rate due to heart disease and cancer. It boggles the mind. Among the 15-24 age group, which surely must be a terribly fragile age, there is one attempt for every 100-200 attempts. For those over 65, there is one successful suicide for every four attempts. For all age groups, the instruments of most successful attempts are rifles and handguns. Their ready availability speaks for itself. Suffocation and hanging are the second most grizzly choices [24] .

The goal of the American Association of Suicidology (AAS) is to understand and prevent suicide. It also serves as a national clearinghouse for information and help, and provides resources and publications on a range of suicide-related topics, including how to read the signs of a potential suicide.

The AAS can be reached at

4201 Connecticut Ave, NW, Suite 408 Washington, DC 20005 202 - 237 - 2283

email: [email protected] Website:

If by nature' s way, suicide and homicide need not be violent. When "the elders" decided that 70-year-old Socrates was too disturbing an influence on young Athenian boys, he was handed an extract of Conium maculatum, spotted hemlock, in wine, of course, with which to dispatch himself to a more propitious environment [25]. Although hemlock's toxic properties were well established by 399 bce, it was not until modern times that coniine (2-propylpiperidine) was isolated and found to be the active (dispatching) essence [26] , However, I've never been certain whether Socrates' death was a suicide or a homicide. I tend toward homicide, as there is little evidence that at his age he entertained the idea of ending it. Conium maculatum is not alone in bringing about the end of days by either suicide or homicide for any number of imbibers.

Recently, another of nature 's wonders made headlines. Cerbera odollam appears to be a ready-made suicide tree, the cause of widespread death on the Indian subcontinent and environs. The suicide tree is seen as the agent of death for many more than had been imagined. Cerbera, which grows across India and southeast Asia, has a long history of assisted suicide, but the scientists who recently studied the problem indicate that the authorities have failed, and are failing, to determine how often it is used for murder.

Writing in the journal Ethnopharmacology , they inform us that cerbera "belongs to the notoriously poisonous Apocynacea family," and they say that the seeds have long been used as an ordeal poison [27]. Ordeal trials were an ancient test used to determine guilt or innocence of sorcery and other crimes. Belief in the infallibility of the poison to make the correct distinction was so strong that innocent people did not hesitate to take a sip.

Cyberin, cerberoside, and odollin, the deadly glycosides, are contained in the kernel. Between 1989 and 1999, 537 deaths were attributed to odollam poisoning. Among those who knowingly took it, 70-75% were women—which continues to speak to their continued oppression. Because of its ready availability, it is the choice poison for both suicides and homicides. For suicide, the kernels are mashed with gur, a form of sweet molasses. For homicide, the kernels are mashed with food containing capsicum-type peppers to mask the bitter glycosides. Death occurs 3-6 hours after ingestion. Although 50 suicides are recorded annually, the actual numbers are unknown, as are the numbers of homicides.

The authors also tell us that "to the best of our knowledge, no plant in the world is responsible for as many suicides as the odollam tree. Mother nature does work in strange ways. The authors further remark that "this study has made it possible to bring to light an extremely toxic plant that is relatively unknown to western physicians, chemists, analysts and even coronors and forensic toxicologists." Yet another caution for our already full agendas.

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