Acetic acid among the means of suicidal actions

A literature review and the authors' own clinical experience on the place of acetic acid (AA) among the means of suicidal action is presented. It is shown that the intake of concentrated solution of AA (70-80% essence) for suicidal purpose was common in the USSR, which can be explained by the widespread use of AA for culinary and household purposes, as well as the prevailing ideas in the population about the possibility of using it for self-harm. At present, the proportion of corrosive substances (including AA) with the aim of deliberate self-poisoning in Russia is not large. The highest rates are recorded in certain post-Soviet states: Azerbaijan - 7.7%, Uzbekistan - 12.4%, Kazakhstan - up to 15%, and Tajikistan. In Russia, 62-87% of cases of taking AA is associated with a suicidal goal (average dose - 55 ml). The number of women prevails in suicide attempts (ratio M:F - 1:1.6-2, mean age - 26-31), among those who died there are more men with mean age of 34. In 44.4% of suicides, alcohol is detected (twice more often in men). Alcohol is also detected in many men who died from an accidental intake of AA, which requires closer attention to the problem, since, according to the authors, unrecognized suicides can often hide behind these cases. Among suicide attempters, persons with a relatively low social status and educational level, often unemployed of working age, predominate. In most cases, the suicidal attempt with AA is made at home, spontaneously, at the top of the conflict or in the immediate period after it, mainly during the day or in the evening on working days. The main background is a family or marital conflict, less often - problems at school or at work. Many suicide attempters have adaptation disorders. A depressive background of disorders prevails. As preventive measures, the necessity of introducing restrictive measures regarding the free sale of concentrated AA, as well as informing the population about the toxic effects of AA, the nature and severity of the damage, and the high probability of subsequent disability, are discussed. The role of the media and the Internet in this direction is significant, and may include several directions: providing general information about the negative consequences of intentional poisoning of AA, the formation of a generally negative attitude to its use for suicidal purposes, as well as information on primary methods of help and opportunities for applying for medical compensation. In conclusion, the authors conclude that it is necessary to improve preventive measures, including those focused on how to manage AA, as well as how to increase the level of knowledge of specialists who assist these patients at all stages of their treatment. The substantiation of the inclusion of certain issues of suicidology in standard training programs and advanced training of medical personnel.