Poisonings, which include ingestions of medications for the purpose of self-harm, are still the most common mechanism of injury though.

Now – are there some caveats here? Of course. These were cases seen in the ED – so maybe people are just going to the ED more when they used to hide these behaviors. That may be a part of this, but it strikes me as very unlikely that that's all of this.

No, to me this seems like a reflection of a fundamental angst afflicting younger women, and increasing over the past 15 years. I'm not sure what the source of that is – whether it is the adolescent female mirror to the rising rate of drug abuse in middle-aged men, whether it is the consequence of a cutthroat social media environment, or something else. But this has the feel of the beginning of an epidemic, and I encourage us all to get out in front of it before it gets worse.