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Aim. To explore suicidal intent among drug users experiencing non-fatal overdose. Design. Semi-structured interviews. Setting and participants. Seventy-seven drug users experiencing non-fatal overdose and attending six hospital accident and emergency departments in two Scottish cities during 1997 and 1998. Measurements. The extent of suicidal intent and motivations for intentional overdosing were examined. Findings. The incidence of suicidal intent was high, with 38 respondents (49%) reporting suicidal thoughts or feelings before overdosing. Suicidal actions were significantly associated with a self-reported history of life-time mental health problems and with not using heroin prior to overdosing, but not with other demographic or drug history data. Qualitative data indicated that intentional overdosing was frequently not driven by a clear and unambiguous desire to die. Furthermore, suicidal actions were motivated by a range of psychosocial factors, including: (i) predisposing personal circumstances; (ii) precipitating events; and (iii) poor individual coping strategies. Conclusions. The issue of suicidal intent needs to be addressed routinely in hospital wards and accident and emergency departments so that the need for support can be assessed.