There is a strong link between substance use disorders and a risk for suicidal behaviors. It has been shown that people who abuse alcohol have higher rates of both attempted and completed suicides than non-abusers. Reports currently state that anywhere between 20 and 50 percent of people that die by suicide had a history of drug or alcohol abuse problems.
Many factors contribute to the relationship between suicide risk and substance abuse. Generally speaking, alcohol and other drug abuse is related to emotional trauma, psychological stress, and other mental health problems. These factors can all play a role in suicidal behaviors. People in emotional pain may use alcohol and other drugs to "self-medicate" or relieve their emotional pain. Over time, alcohol and other drugs are more likely to increase emotional distress than provide an escape. People who abuse or are dependent on alcohol are at approximately 10 times greater risk for suicide. People who inject drugs are at about 14 times greater risk for suicide.
Alcohol use impairs judgment and can lead to impulsive behavior. Someone who may not have made an attempt sober may do so under the influence of drugs or alcohol. Alcohol is associated with impulsive suicides, especially those involving firearms. Please note, we are not saying all suicides are impulsive or that drugs and alcohol play a factor in all suicides, but the risk is higher of suicide when alcohol is involved.
People who use drugs or alcohol are thought to be at a greater risk for suicide because of the effects drugs and alcohol can have including disinhibition, intense focus on the current situation with little appreciation for consequences, and promoting depressed moods in people using substances.
Suicide warning signs and risk factors are similar for people that abuse drugs or alcohol and those people that do not. Risk factors include:
- Current or recent interpersonal loss.
- Separation from a spouse
- Interpersonal conflict
- Loss of employment
- Threatened loss of employment
- Physical illness
- Perceived or real loss of social supports
- Financial loss
- Depression, especially feelings of hopelessness and burdensomeness.
- Other psychiatric problems.
- Anxiety disorders
- Bipolar disorders
- Impulse control disorder
- Other comorbid DSM Axis I and II disorders
- Family history of suicide, mood disorders and/or alcohol abuse.
- Recent return to or escalation of drug and alcohol.
For treatment providers
As an addiction counselor, you work with people who have behaved in ways that are, by definition, self-destructive and who are at elevated risk of suicide. The relationship that you build with your clients may encourage them to ask for help from you, sometimes directly and sometimes indirectly. It is important to have policies and procedures in place to address such issues. It could help save a life.
If someone is in treatment for drugs or alcohol, it is important to note that suicide risk may increase at certain points in treatment such as the transition from inpatient to outpatient treatment, intensive treatment to a less intensive program and at discharge from a treatment program. Another time to be especially watchful for suicide warning signs is after someone lapses or relapses on substances. When working on a treatment plan, it is important to address the most severe and life-threatening issues first.
It is important for addiction counselors to know how to respond to clients who may be in imminent danger of harming themselves. The goal is to keep the client safe, providing empathy and support, and ensuring that the client receives the mental health services needed to reduce the risk of suicide.
Information adapted from Substance Abuse and Mental Health Services Administration and the Suicide Prevention Resource Center.