Many studies have determined a strong correlation between substance abuse and suicide, and high suicide risk among those with comorbid psychiatric and substance use disorders.
Substance use disorders along with psychiatric illnesses and aggressive behavior disorders are the most influential risk factors for suicide, especially among adolescents.
Studies indicate that people who abuse drugs and alcohol from a very young age, especially in early adolescence, are at much higher risk of suicidal behaviors and attempts later on in life.
Below, we’ll discuss some of the primary links between suicide and addiction so you can better spot the potential warning signs in a loved one.
If you or a loved one are experiencing thoughts of suicide, call or text 988 to reach the National Suicide Prevention Lifeline.
How Suicide And Substance Abuse Are Connected
According to recent data, 90% of fatal suicide cases met the criteria of a psychiatric diagnosis, including substance use disorders and addiction.
Mental health issues are known to be the highest risk factors for self-harm behaviors and suicidal ideations, attempts, and fatalities.
Alcohol and drug addiction are major contributing factors to mental illness, as substance abuse can trigger and exacerbate symptoms of mental health disorders.
The Warning Signs Of Suicide
Suicide is a tragic potential consequence of treatable mental health issues that can escalate to a point of crisis when distressing emotions such as hopelessness and despair become overwhelming.
Knowing the warning signs of suicidal ideations is imperative for intervening on someone’s behalf and helping them get the mental health treatment they need to be safe.
Warning signs and behaviors that indicate the imminent danger of suicide can be more apparent or subtle depending on the person and may manifest gradually or escalate rapidly.
Recognizing suicidal behaviors without delay is critical for timely intervention.
People in a state of extreme emotional stress can also dissociate from reality and hurt themselves without understanding the consequences of their actions.
Drugs and alcohol can exacerbate a serious situation by impairing mental faculties and decreasing inhibitions. This can cause people to act impulsively, erratically, and violently.
If you’re worried that your loved one may be at risk of suicide, read some of the common warning signs below to decide if it’s time to get help.
Behavioral signs of suicidal risk include:
- increasingly severe mood swings
- increased use of alcohol or drugs
- sleeping very little or too much
- withdrawal from friends and loved ones
- sudden outbursts of violence or anger
- sudden calmness or placid behavior
- lack of emotional reaction or response
- dangerous and reckless behaviors
- sudden personality shifts or changes
- sudden changes in appearance
- talking about suicide, or making threats
- showing extreme sadness or hopelessness
- unusual activities, such as preparing a will
- sudden interest in firearms or other weapons
Suicide And Substance Abuse Prevalence
The prevalence of suicide risk among people with substance use disorders and co-occurring mental health issues is, unfortunately, high.
According to the Centers for Disease Control and Prevention (CDC), alcohol intoxication was involved in 22% of suicide fatalities, and between 30% and 40% of suicide attempts.
Alcohol was followed by:
- opiates: 20% of suicide cases
- marijuana: 10.2% of suicide cases
- cocaine: 4.6% of suicide cases
- amphetamines: 3.4% of suicide cases
Self-medication is believed to be one of the primary reasons behind the involvement of alcohol and drug abuse in mental health conditions that result in suicide attempts or fatalities.
Researchers are still trying to understand the full extent of the correlation between substance abuse and suicidal behaviors, and what other variables are involved in this relationship.
But understanding even just part of the connection between suicide and substance abuse allows for more effective dual diagnosis treatment and suicide prevention strategies.
Researchers have found that suicide risk is higher among people who meet the following criteria:
- recently lost a spouse or went through a divorce
- have attempted suicide previously
- have a family history of suicide
- work in law enforcement or hospice healthcare
- have a history of substance abuse or are in active addiction
- have been recently discharged from a psychiatric hospital or institution
- have a recent experience with a friend or loved one committing suicide
- are prone to violence or have a history of violent, unpredictable behavior
- have a history of mental illness
- have a history of emotional, sexual, or physical abuse and trauma
- have a terminal illness or deal with long-term chronic pain
People with underlying behavioral health issues such as impulsivity are increasingly vulnerable to suicide risk, especially when substance abuse is an additional factor.
Environmental and socioeconomic stressors such as poverty, geographical isolation, racial and sexual discrimination, and trauma can put people at greater risk of suicide and addiction.
The prevalence of addiction and suicide is higher among these populations:
- combat veterans
- Native Americans
- Alaskan Natives
- people in low-income, rural areas
- LGBTQ+ young adults
Does Alcohol Or Drug Abuse Increase The Risk Of Suicide?
Suicide risk and addiction are closely interconnected for many people who live with alcohol or opioid abuse in addition to mental health issues.
According to the Centre for Suicide Prevention (CSP), drug and alcohol abuse is the second most acute risk factor for suicide after depression. This risk increases with co-occurring disorders.
People who are chemically dependent on drugs or alcohol are 10 to 14 times more likely to display suicidal behavior.
The combination of alcohol and opioid use with suicide is most frequently reported in association with suicidal attempts and fatalities.
Alcohol Abuse And Suicide
Alcohol abuse can worsen mental health conditions, especially depression, anxiety, schizophrenia, bipolar disorder, and post-traumatic stress disorder (PTSD).
Alcohol intoxication also aggravates impulsivity and decreases inhibitions, which for someone in an altered state of mind and extreme emotional distress can increase their suicide risk.
Statistically, people who abuse alcohol have five times the likelihood of dying by suicide than people who drink socially.
Opioid Abuse And Suicide
Chronic opioid use and acute opioid use disorders are also closely linked to an increased risk of suicidal behavior.
These cases occur among people who abuse opioids with or without comorbid mental health disorders and psychiatric illnesses.
Opioid abuse impairs cognitive function and causes neurotoxic damage. This increases the likelihood of someone under the influence acting on self-destructive and suicidal ideations.
Illicit Drug Abuse And Suicide
In addition to the studied effects and impacts of alcohol and opioids on suicidal behavior, other forms of illicit drug abuse are also known to be severe risk factors for suicide.
According to the CSP, drug and alcohol abuse is the second most acute risk factor for suicide after depression. The risks increase with co-occurring disorders.
Any substance that impairs mental function and distorts the perception of reality can increase the risk of suicidal behavior, especially when mental health issues and disorders are a factor.
Illicit stimulant drugs such as meth are known to cause psychosis, hallucinations, and impulsivity, all of which increase the risks of suicidal behaviors.
Meth use combined with schizophrenia disorders has an even higher risk of causing people to act on suicidal ideations and disassociate from reality while in meth-induced psychosis.
Gender Differences In Substance Abuse And Suicide Risk
In general, women are considered at higher risk of comorbid substance abuse and suicide than men, due to additional social stressors and risk factors such as sexual trauma.
According to statistical findings, women are three times more likely to attempt suicide than men, but men are more likely to die from suicide attempts.
What To Do If Your Loved One Expresses Suicidal Thoughts
If you believe a loved one or family member may be expressing suicidal behaviors, it is appropriate to intervene on their behalf and address potential risks.
You can start by:
- letting your loved one know that you’re there for support, and that you’re listening
- asking why they’re feeling this way, and if there is anything you can do to help
- encouraging your loved one to seek professional counseling and addiction treatment
If you believe the situation is serious and help is needed immediately, be direct: “Are you contemplating committing suicide?” If they respond with yes, do not leave them alone, and call 911 right away.
The following behaviors are red flags of serious suicidal ideations:
- sudden personality shifts and erratic behavior
- talk of feeling desperate, hopeless, or trapped with no way out
- making a plan for suicide
- expressing intent to harm themselves or others
Reach out to someone for support in the meantime and stay with your loved one until help arrives. If they’re open to it, you may be able to take them into emergency care yourself.
If you are concerned that someone may be a danger to themselves and their life is at risk, they should be assessed and monitored in a safe, clinical setting.
Once your loved one is in a stable environment, a diagnosis and proper treatment can be determined.
Suicide Prevention Measures
Although suicide is prevalent among people who live with mental health and substance abuse issues, it is preventable if the right measures are taken in a timely manner.
The World Health Organization (WHO) recommends four key intervention strategies that can help to prevent suicides from occurring.
WHO intervention strategies are the following:
- limit access to weapons and other means of self-harm or suicide
- help bring awareness to suicide risk and prevention
- foster positive coping and life skills among youth and adolescents
- support people who are affected by suicidal behaviors
Other prevention strategies include helping people who are affected directly or indirectly by suicide, addiction, and other mental health issues get access to professional support.
If you know that a friend, family member, co-worker, or neighbor is going through mental illness and addiction, make sure they know you’re available for support.
The antidote to isolation, depression, addiction, and suicide is often community and support from loved ones.
Though you have no control over another person’s thoughts or actions, you can provide physical support and words of encouragement.
Treatment For Addiction And Suicide
With the appropriate intervention strategy and treatment approach, suicide is preventable and addiction is treatable, whether they are interrelated or independent of one another.
Whatever underlying mental health issues there may be, long-term recovery is possible.
Treatment approaches for co-occurring addiction and suicide typically entail:
- an inpatient or outpatient rehab program
- individual addiction therapy with a licensed therapist trained to address co-occurring addiction and mental health disorders
- group therapy and support groups
Social and emotional support from local communities and family systems are also integral to effective addiction treatment and suicide prevention.
There is strong evidence to support the theory that people who are connected to a support network decrease their risk of suicide and increase their chances of success in recovery.
Resources For Loved Ones
If you or a loved one have been impacted by suicide and addiction, the following resources are available to help you or them find support from professional and community networks.
- CDC: Preventing Suicide: A Technical Package of Policies, Programs, and Practices
- National Institute of Mental Health: Brochure on Warning Signs of Suicide
- SAMHSA: TIP 50: Addressing Suicidal Thoughts and Behaviors in Substance Abuse Treatment
- 988 Suicide & Crisis Lifeline: a 24/7 hotline for anyone in need of live support
- The Trevor Project: an LGBTQ+ resource with live support access to crisis counselors
- Action Alliance for Suicide Prevention: Outpatient Health Care Self Assessment
- Online Media Guide: Recommendations for Reporting on Suicide
- Society for the Prevention of Teen Suicide: Behavioral Health Toolkit for parents
- My Support Forums: an online community of mental health support groups
- The Samaritans: an online source of free and confidential emotional support
- ULifeline: an online mental health resource for college students with a self-screener
- Centre for Suicide Prevention – Substance Use Disorder and Suicide https://www.suicideinfo.ca/resource/substance-use-disorder-suicide-prevention/
- MD Edge Psychiatry – The ‘meth’ epidemic: Managing acute psychosis and suicide risk https://www.mdedge.com/psychiatry/article/62438/meth-epidemic-managing-acute-psychosis-agitation-and-suicide-risk
- National Library of Medicine – Epidemiological Evidence on the Link Between Drug Use and Suicidal Behaviors Among Adolescents https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2538629/
- Psychiatry Online – A Closer Look at Substance Use and Suicide https://psychiatryonline.org/doi/10.1176/appi.ajp-rj.2018.130603
- Psychiatric Times – The Link Between Substance Abuse, Violence, and Suicide https://www.psychiatrictimes.com/view/link-between-substance-abuse-violence-and-suicide
- Substance Abuse and Mental Health Services Administration – Substance Use and Suicide https://store.samhsa.gov/sites/default/files/d7/priv/sma16-4935.pdf