Sodium nitrite, nitrate self-poisoning emerges as growing suicide method among youth

Sodium nitrite, nitrate self-poisoning emerges as growing suicide method among youth | Image Credit: © New Africa - stock.adobe.com.

An emerging suicide method involving ingestion of sodium nitrite and nitrate is increasingly being used by adolescents and young adults, according to new research presented at the American Academy of Pediatrics (AAP) 2025 National Conference & Exhibition in Denver, Colorado.^1,2

The study, Emerging Trend of Sodium Nitrite and Nitrate Self-Poisoning: Fatality Review Challenges and Public Health Implications, analyzed pediatric fatalities from 2018 to 2023 and identified concerning patterns. Researchers found that young people using these chemicals as a means of suicide were more likely to have recent healthcare encounters that could serve as points for prevention.

“There are a variety of prevention opportunities resulting from this work, including increasing awareness about the growing use of sodium nitrite and nitrate in self-harm, providing suicide prevention resources that specifically address this method, and informing the public about the ease of access to these chemical compounds online,” said research author Frank Pleban, PhD, associate professor at Tennessee State University.

Study design

Researchers used data from the Pediatric National Fatality Review–Case Reporting System (NFR-CRS). Two groups were analyzed: 34 adolescents aged 14 to 21 years who died by sodium nitrite/nitrate or other salt-based poisoning, and 4,544 adolescents who died by suicide from other causes.

Demographics, mental health history, and health care utilization patterns were compared between the two groups to identify distinguishing factors.

Key findings

The analysis revealed several trends:

• Age: Mean age was 16.7 years in the sodium nitrite/nitrate group compared with 16.0 years in the non–sodium nitrite group. Thirty-eight percent of the sodium nitrite/nitrate group were 14 to 16 years old, compared with 64% in the non-sodium nitrite/nitrate group.
• Demographics: White adolescents comprised 62% of sodium nitrite/nitrate suicides, followed by Asian adolescents at 24%. In comparison, the non-sodium nitrite/nitrate group was 73% White and 12% Black. Males accounted for 71% of the sodium nitrite/nitrate group.
• Healthcare encounters: Adolescents who died by sodium nitrite/nitrate poisoning were more likely to have seen a healthcare provider within the month prior to death (13% vs 8%), to have had a mental health–related emergency department visit in the year prior (13% vs 9%), and to have been hospitalized for mental health issues (20% vs 9%).
• Other factors: They were less likely to have received prior mental health services (21% vs 26%), to have a history of substance use (6% vs 22%), or to have experienced maltreatment (6% vs 21%).

These findings align with national data. A previous study of the National Violent Death Reporting System identified 260 sodium nitrite/nitrate suicides between 2018 and 2020, most among White males with histories of depression and suicidal ideation.

Public health implications

Both sodium nitrite and sodium nitrate are commonly used as curing agents in the meat production industry and are easily purchased online in powder form. When ingested, they can cause methemoglobinemia, leading to hypoxia and potentially fatal outcomes.

“Public health professionals are uniquely situated to identify emerging risks in their communities. This early identification saves lives,” said study co-author Abby Collier, DrPH, director of the National Center for Fatality Review and Prevention.

The authors highlighted the need for safeguards, including training emergency responders and health care providers to recognize symptoms of sodium nitrite/nitrate poisoning, and developing suicide prevention resources that specifically address this method.

Conclusion

The research emphasized that pediatricians, emergency physicians, and community health workers may encounter opportunities for early intervention, as many affected adolescents had prior healthcare visits. By strengthening awareness, screening, and crisis response strategies, health professionals can help mitigate risks associated with this emerging suicide method.

References:

1. American Academy of Pediatrics. Sodium nitrite and nitrate increasingly used in youth suicide attempts. Eurekalert. September 26, 2025. Accessed September 26, 2025. https://www.eurekalert.org/news-releases/1098753
2. Pleban F. Emerging Trend of Sodium Nitrite and Nitrate Self-Poisoning: Fatality Review Challenges and Public Health Implications. Abstract. Presented at: American Academy of Pediatrics 2025 National Conference & Exhibition. September 26-30, 2025. Denver, Colorado.