Suicide is one of the leading causes of death in the United States, resulting in roughly 35,000 fatalities every year. In addition, nearly 11,000,000 American adults attempt suicide without success at some point in their lives. Altogether, people who abuse alcohol and/or drugs attempt to kill themselves nearly six times as frequently as people who don’t abuse these substances. In some cases, substance abusers attempt to kill themselves through means not directly related to alcohol or drugs. However, in many cases, they commit suicide through an intentional substance overdose. Suicidal substance abusers tend to have certain emotional and behavioral problems that strongly influence their actions.
Only the mood disorders depression and bipolar disorder increase a person’s risks for suicide more than alcohol or drug abuse, according to the National Center for Injury Prevention and Control. Roughly 33 percent of all successful suicides involve people with significant amounts of alcohol in their systems, and nearly two-thirds of these alcohol-affected individuals were legally drunk when they died. In addition to lowering inhibitions and contributing to a loss of mental or emotional control that can increase short-term suicide risks, use of alcohol or drugs can also contribute to the onset of depression, which in turn can act as the main short-term influence on a suicidal person’s state of mind. Roughly 70 percent of people who commit suicide by intentional overdose use only a single substance to achieve their goal. In almost 80 percent of these single-substance suicides, the drug of choice is some sort of prescription medication. In decreasing order of frequency, the other substances most commonly used on their own in suicides include acetaminophen and other nonprescription medications, categories listed as “other specified substances” and “unknown drugs,” illegal street drugs and alcohol. People who commit suicide with two or more substances most commonly combine alcohol with some kind of prescription drug. Other substance combinations used during suicides include alcohol combined with a nonprescription drug, a prescription drug combined with an illegal street drug, alcohol combined with both prescription and illegal drugs, and alcohol combined with just illegal drugs. Large numbers of people also kill themselves with an unspecified or unknown combination of substances. Women are roughly four times more likely to intentionally kill themselves with alcohol and/or drugs than men, the National Center for Injury Prevention and Control reports. White males intentionally kill themselves with alcohol and/or drugs roughly twice as often as black males. Out of all people between the ages of 40 and 64 who commit suicide, nearly 20 percent do so with drugs or alcohol. Conversely, out of all people age 17 or younger who commit suicide, less than 5 percent do so with drugs or alcohol.
Substance abusers and people without substance abuse issues share many of the same basic risk factors for suicidal thinking and active suicide attempts, according to a 2011 study review published in the journal Psychiatric Times. Among these factors are a history of major depression or any other severe mental disorder, social isolation, serious physical illness, a family history of suicide, a personal history of childhood abuse or neglect, a personal history of previous suicide attempts, a tendency toward aggressive or impulsive behaviors, lack of access to adequate mental health-related resources, and convenient access to a lethal substance or device. In addition to depression that develops from other sources, substance abusers also have risks for depression that stem directly from the effects of drug or alcohol use. Male drug abusers with a mental disorder that produces an abnormal or unhealthy emotional reliance on others have higher suicide risks than other male drug abusers, according to a study published in 2002 in the journal Substance Use & Misuse. Female drug abusers with a mental disorder that increases risk-taking or impulsivity have similarly elevated risks when compared to other female drug abusers. In a separate study published in 2005 in Psychiatry Research, French researchers reported that male drug abusers and female alcoholics also have increased risks for suicide when they develop a condition called dependent personality disorder, or any other mental disorder that produces unusual levels of emotional dependence on others.
Use/abuse of certain substances may produce higher suicide risks than use/abuse of other substances, the authors of the 2011 study review in Psychiatric Times explain. Specific types of drugs that can contribute to higher suicide levels include sedative-hypnotic medications (barbiturates and benzodiazepines), cocaine, and legal and illegal opioids. Among alcohol abusers and alcoholics, periods of especially high alcohol intake tend to result in higher suicide risks than periods of relatively low alcohol intake. Generally speaking, suicide risks may increase in people who abuse more than one drug, as well as in people who have simultaneous addictions to both drugs and alcohol.