Suicide and Substance Use

In America, one person dies by suicide every 13 minutes. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), it is the 2nd leading cause of death for teens, and the leading cause of death among people with substance use disorders. There is a strong association between mental health issues that may lead to suicide and substance use. The biggest risks of suicide include prior attempts, a current mood disorder, substance abuse, and access to means. Research also suggests that males are more likely to complete a suicide than females.

Most people who become suicidal will, when discussing their feelings, acknowledge that if the main stressors in their life were resolved, they would not feel suicidal. However, most feel suicidal because they do not see any hope of resolution. Talking a situation through with another person often yields thoughts, ideas, and new perspectives that had not occurred to the person before. Options are identified and despair is lessened. Therefore, taking the time to talk, listen, and support what a depressed person feels is essential. People need to know that those around them believe them and believe in them, even (and especially) at a time in life when they may have difficulty believing in themselves.

Trained therapists play a vital role in helping identify and explore what someone may be experiencing. In therapy, counselors can ask the direct questions that others might want to shy away from like, “Do you want to kill yourself?” and “How would you do it?” These are critical questions to get the topic out in the open and possibly save a person’s life. In addition, nationally recognized tools can help reveal thoughts and plans for suicide in individuals of all ages, such as the CAMS model (Collaborative Assessment and Management of Suicidality) and the Columbia Suicide Rating Scale. While it may become clear that someone you know is in need of professional help, it is also important to consider yourself and other family members’ needs and seek support through individual, group, or family counseling.

Suicide is often an impulsive act. Therefore, finding ways to slow down a possibly lethal impulse is key and limiting access to means of committing suicide is critical. Intoxication increases the chances of impulsive behavior, as the brain’s ability to make appropriate decisions becomes impaired by use. According to Schoenbaum, Roesch, and Stalnaker (2006) the prefrontal cortex has a role in our executive functions. This area contributes to our ability to anticipate events, and to use that information to guide decisions. Damage or impairment to this area—that can be caused by substance use—leads to the kind of impulsiveness that is common in those who are addicted.

As above, SAMHSA reports that suicide is the leading cause of death among people with substance use disorders. Alcohol is present in 30-40% of suicides and drug related suicide attempts increased by 41% from 2004-2011. According to the US Dept of Health and Human Services (HHS), “A review of minimum-age drinking laws and suicides among youths age 18 to 20 found that lower minimum-age drinking laws were associated with higher youth suicide rates.”

The HHS also reports, “Substance use and abuse can be common among persons prone to be impulsive, and among persons who engage in many types of high-risk behaviors that result in self-harm.” Many people who are addicted are looking for relief from uncomfortable feelings or escape from the stresses in their lives. A parallel develops between their tolerance for substances and their tolerance for risk and self-harm. For those who might observe this pattern, they may discover that minimization is a standard defense of addiction. Thus, even as the risk grows, the addicted user insists that everything is fine. At the same time, the relief an addicted user finds includes lowering of inhibitions, which most substances, especially alcohol, provides. For someone who is feeling uncomfortable in their own skin to begin with, this is a dangerous situation, one in which one’s lowered inhibitions lead them to impulsively act out in ways he/she would not do if sober. In this way, many people self-harm, or attempt or complete suicides who would not have done so had they not been intoxicated.

The Warning Signs of Addiction

  • Increase of use of substances.
  • Increased tolerance to substances.
  • Irritated or minimizing response to other’s comments about their use.
  • Attempts to hide use.
  • Neglecting or dropping obligations.
  • Acquiring new but unhealthy relationships.
  • Poor judgment.
  • Chronic low-level sickness.

Some of The Warning Signs of Suicide

  • Visible changes in behavior from what is normal or usual for that person, including increased irritability or hostility, or social withdrawal.
  • Trauma or stress that the person does not seem able to get past.
  • Talking about or threatening to hurt oneself.
  • Seeking means to hurt or kill oneself.
  • Talking about or writing about death, dying, or suicide.
  • Statements such as, “I will just end it all.”
  • Hopelessness, feeling trapped with no options.
  • Seeing no reason for living or purpose in life.
  • Being unable to sleep or sleeping all the time.
  • New or increased alcohol or drug use.
  • Acting reckless or making very risky decisions with no care for the outcome.

Suicide and addiction are both preventable and treatable. Take the time to read, listen, and learn what you can do to help save a life.

If someone you know is in immediate danger, always call 911. Another important number is the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK)

Jane Amsden, LCSW-R, is the Program Director of Mental Health Counseling & Treatment Services at CoveCare Center in Carmel, NY. CoveCare Center, formerly known as Putnam Family & Community Services, partners with individuals, families, and the community to foster hope, wellness, and recovery, and to restore quality of life by addressing mental health needs, substance use, and social and emotional issues. For more information, visit, email, or call (845) 225-2700.

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