Substance Use Disorders (SUDs) coupled with suicide are a critical dual concern that has severe implications for the public health of the entire world. The National Institute on Drug Abuse (NIDA) also reports that people with SUDs are more prone to suicide, with statistics showing that their risk is six times higher than that of a non-addicted population. However, a report by USA FACTS shows that in the US, for example, about 46,003 people died by suicide in 2022, out of which about 30 percent met the criterion of alcohol or drug use. These alarming statistics highlight the urgent need for effective interventions and the role families and friends can play in supporting those affected. Substance abuse and suicidal behavior are often interrelated due to common factors like mental illnesses, isolation, and trauma that make it challenging to stop the cycle without intervention.
The Overlap Between Substance Use Disorders and Suicide
SUDs began to affect brain chemistry and kill off neurons, explicitly relating to serotonin and dopamine, which regulate moods. Substance dependency persists with diminished concentrations of serotonin; all of these affect the individual’s ability to process emotions and put him at risk of developing depression and anxiety issues. These mental health conditions are significantly associated with suicidal ideation, meaning that the use of substances makes mental health worse and vice versa.
Also, alcohol and opioids distort judgment and self-control, provoking many virtually negligent actions, including self-harm. Studies presented in the Journal of Psychiatry & Neuroscience also demonstrate that under the influence of substances, the ability to predict outcomes is diminished, and attempting suicide during crises is more likely.
High-Risk Groups and Factors
Demographic Considerations
Specific populations are more at risk for co-occurrence of SUDs and suicide than others. According to the USA Facts, the suicide rate among the American Indian and Alaska Native communities is nearly double the national average; this is attributed to high substance dependency coupled with restricted access to mental health services. Veterans are also one of the high-risk populations, and it is estimated that 20 veterans commit suicide each day, and many of them have alcohol dependence or misuse.
Socioeconomic and Environmental Factors
Challenges like poverty, unemployment, and housing insecurity often drive individuals toward substance use as an escape, perpetuating cycles of despair. The stigma surrounding mental health and addiction further isolates individuals, deterring them from seeking help.
Intervention Strategies to Address the Crisis
Early Detection and Screening
Standard assessment for suicidality should be performed in people with SUDs. Practitioners can administer the Columbia-Suicide Severity Rating Scale (C-SSRS) to evaluate patients for early signs of risk. Hence the reason early detection contributes to minimized instances of improper efforts at committing suicide. A 2023 study published in the National Library of Medicine determined that incorporating a screening process into emergency care decreased SUD patients’ suicide rates by 30%.
Integrated Treatment Models
Another model of treatment is an integrated treatment where both SUD and mental health disorders are treated at the same time. This model integrates CBT, pharmacotherapy, and supportive interventions. Thus, the patients will receive a holistic treatment. Integrated care is also effective in the prevention of suicidal behavior, having been recognized by the Substance Abuse and Mental Health Services Administration (SAMHSA) to reduce risks by 25% due to the treatment of the related mental illness to substance use.
Cognitive Behavioral Therapy or (CBT)
The utilization of CBT is widespread for reducing suicidal thoughts in those with SUDs. It teaches patients to recognize and change how they think and cope. According to the American Psychological Association (APA), CBT has been proven to reduce up to 50 percent of suicidal ideation, especially if substance misuse treatment is added to CBT.
Crisis Intervention and Support Services
The 988 Suicide & Crisis Lifeline, a crisis helpline, reaches out to people in crisis. Counseling, local mental health resource referral, and de-escalation of crises are the services these offer. Utilizing such services in such a way to expand their availability and accessibility will help reduce the rates of suicide among people with SUDs.
Medication Assisted Treatment (MAT)
Based on FDA-approved medications and counseling, MAT successfully reduces cravings and withdrawal symptoms, keeps patients stable, and reduces suicide risk. A low dose of approved drugs, such as buprenorphine and naltrexone, can minimize opioid dependency and lead to less production of the local chemical known to cause suicide attempts – dopamine. A report produced by the Substance Abuse and Mental Health Services Administration (SAMHSA) notes that MAT programs can decrease opioid-induced suicides by up to 60 percent.
Community and Policy-level interventions
Peer Support and Recovery Community
Peer support programs are vital to the community and address social isolation. Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are organizations providing a setting where people tell their stories and give mutual encouragement. There have been studies that demonstrate that peer support groups result in favorable mental health outcomes and decreased suicidal ideation.
Public Awareness Campaigns
Reducing stigma against SUDs and mental health is an important educational campaign. More people will get help and support when they increase public awareness. A study states that Community-based education programs focused on recognizing and treating suicide and substance misuse earlier in the community can reduce rates of suicide by more than 50%, according to the WHO.
Policy Reforms
As mentioned by governments, more access to mental health and addiction treatment services needs to be guaranteed. The research into the SUD-suicide link needs funding and concrete legislation that limits access to harmful substances that have long-lasting effects. The Centers for Disease Control and Prevention (CDC) supports comprehensive preventive care policies and immediate intervention strategies.
How Families and Friends Can Help
Families and friends are central to the lives of persons with SUDs and suicidal ideation and are part of the recovery process. That is how they may help.
- Recognize Warning Signs – Note any behavior change, such as loss of interest in daily activities, bad temper, or feeling of helplessness. Getting an early diagnosis will mean early treatment.
- Thumb The Treatment and Support – Promote professional assistance, make appointments with them, and assist in complying with prescribed regimens.
- Limit Exposure to Toxic Products – Protect settings by restricting the availability of alcohol, drugs, or any other form of harm.
- Stay Involved – Engaging in recovery, not only by going to family therapy sessions or support meetings, will enhance the patient’s commitment to change.
- Foster a Positive Environment – Practice healthy lifestyle habits, leisure activities, and the overall regimen to discourage relapse while at the same time discouraging suicidal thoughts.
Conclusion
Combating the dual phenomenon of Substance Use Disorders and suicide is a community endeavor. Healthcare providers and policymakers perform some of these roles, but the real mobility support mainly comes from families and friends. When it comes to mental health, they make a difference by identifying potential indications of developing a mental illness, showing encouragement as well as getting involved in treatment. As a society, we can work to combat the stigma, offer hope, and use the tools needed to help people make the necessary changes to save their lives and lead happier, healthier lives.
Temitope Fabayo, BA, MBA, is President of DMC HomeCare.
References
Dillon, E. C., Huang, Q., Deng, S., Li, M., Ernell de Vera, Pesa, J., Nguyen, T. H., Kiger, A. J., Becker, D. F., & Kristen M.J. Azar. (2023). Implementing universal suicide screening in a large healthcare system’s hospitals: rates of screening, suicide risk, and documentation of subsequent psychiatric care. Translational Behavioral Medicine. https://doi.org/10.1093/tbm/ibac117
How many people die by suicide in the United States each year? | USAFacts. (2022). Usafacts.org. https://usafacts.org/answers/how-many-people-die-by-suicide/country/united-states/
Medication-Assisted Treatment Improves Outcomes for Patients With Opioid Use Disorder. (2016, November 22). Pewtrusts.org. https://www.pewtrusts.org/en/research-and-analysis/fact-sheets/2016/11/medication-assisted-treatment-improves-outcomes-for-patients-with-opioid-use-disorder
Smith, R., Lavalley, C. A., Taylor, S., Stewart, J. L., Khalsa, S. S., Berg, H., Ironside, M., Paulus, M. P., & Aupperle, R. (2023). Elevated decision uncertainty and reduced avoidance drives in depression, anxiety and substance use disorders during approach–avoidance conflict: a replication study. Journal of Psychiatry & Neuroscience, 48(3), E217–E231. https://doi.org/10.1503/jpn.220226
Stringer, H. (2024, January 1). Psychologists are innovating to tackle substance use by building new alliances in treatment efforts. Apa.org. https://www.apa.org/monitor/2024/01/trends-psychologists-tackling-substance-use
SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION 2021 Report to Congress on the State Opioid Response Grants (SOR) Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment. (n.d.). https://www.samhsa.gov/sites/default/files/2021-state-opioid-response-grants-report.pdf
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