Alcohol and Other Drug Misuse
Substance use is the second most common risk factor for suicide. Alcohol misuse or dependence increases risk tenfold. In fact, 22% of suicide deaths and 30-40% of suicide attempts in the U.S. involve alcohol intoxication. Opiates are present in 20% of suicides, while injection drug use increases risk fourteen-fold.4
Reasons for the connection between substance use and suicide include:4
- Disinhibition during intoxication
- Increasing depressed mood
- Increases in psychological distress and aggressiveness
- Propulsion of ideation into action
- Constriction of cognition, impairing one’s ability to generate and implement alternative coping strategies
Opioid Overdose and Suicide Deaths Continue to Rise in Tandem and Are Hard to Distinguish
As opioid overdose deaths continue to rise dramatically, suicide steadily increases in the shadows. Still, it is estimated that 20-30% of deaths being attributed to opioid overdose are actually suicides.5 This is particularly problematic because interventions targeting unintentional overdoses are different from those that target intentional overdoses. As such, most strategies aimed at combatting the opioid epidemic do not include screening or intervention for suicide risk.5 This highlights the importance of addressing these two issues in tandem as self-injury mortality.6
Addressing Substance Use and Suicide Collaboratively
In 2016, the Substance Abuse and Mental Health Services Administration (SAMHSA) issued a call to action to address substance use and suicide with collaborative efforts in its brief Substance Use and Suicide: A Nexus Requiring a Public Health Approach. Here are a few strategies for addressing the two public health crises together.
- Providing suicide prevention training and resources to substance use prevention and treatment providers serving a variety of settings including schools, college and university campuses, juvenile and criminal justice organizations, communities, and substance use disorder treatment programs
- Promoting collaboration between community suicide and substance use/opioid prevention task forces or coalitions
- Implementing suicide safer care protocols into substance use disorder treatment settings
- Providing naloxone training to those who interact with suicidal individuals. Administration of naloxone, also referred to as Narcan, reverses an overdose.
- Integrating suicide risk screening, safety planning intervention, referral, and monitoring into the alcohol and drug Screening, Brief Intervention, and Referral to Treatment (SBIRT) model
- Providing identification and early intervention services for alcohol and other drug misuse to address a major risk factor for suicide
- Integrating suicide prevention into opioid overdose prevention materials and resources
- Referencing the issues together as self-injury mortality, when discussing the issue and advocating for support and resources
Visit the New York State Office of Alcoholism and Substance Abuse Services Combat Addiction for information, toolkits, videos, and materials on opioid overdose prevention. Click here to find a naloxone training near you.
Recovery is possible. Call the NYS HOPEline at 1-877-8-HOPENY (1-877-846-7369) to speak to a trained clinician.