Do People With Substance Use Disorder Have Higher Suicide Risk?

For people with substance use disorder, suicide and self harm are serious risks.

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Demanding that people with substance use disorder receive equal respect, care, and support as people with other types of chronic mental health conditions, is key to breaking the cycle and saving lives.

Suicide prevention is a top priority in the treatment of substance use disorders. New research published in the Journal of Affective Disorders showed that individuals with SUD who attempt suicide have potentially avoidable or treatable risk factors, particularly psychiatric hospitalization, sedative use disorders in women, and nicotine dependence in men. Addressing these co-occurring risk factors may help save lives.

For people with substance use disorder, suicide and self harm are serious risks. Recurrent suicide attempts are common in this patient population and are associated with successful attempts that result in death. Sixty-one percent of people with substance use disorders who attempt suicide report recurrent suicide attempts.

In the current study, researchers sought to identify risk factors for recurrent suicide attempts, controlling for gender and addictive substance exposure, by assessing the lifetime history of 433 people with substance use disorder who were in outpatient treatment. The study collected data from mostly men (77 percent) with either cocaine or opiate use disorder, using standardized questionnaires.

Of the total 433 participants, 32 percent had attempted suicide, and 61 percent of this subgroup reported 2 or more suicide attempts. Women reported more lifetime attempts than men.

According to Psychiatry Advisor, the study researchers did identify a number of risk factors for recurrent suicide attempts that are treatable or avoidable. Most of these risk factors “are highly prevalent in treatment seeking individuals with [substance use disorders],” and are similar to risk factors for serious suicide attempts, suggesting “a common liability towards suicidal behavior.”

No data was available in the study for people with other types of substance use disorder, or people who were non-binary or transgender. However, it is known that homophobia and other social stigma can be a contributing factor to both suicide and addiction.

Suicide rates have risen dramatically in the United States. Their exponential increase mirrors the rising number of substance use related deaths. According to the Washington Post, “Nearly 45,000 suicides occurred in the United States in 2016 — more than twice the number of homicides — making it the 10th-leading cause of death. Among people ages 15 to 34, suicide is the second-leading cause of death.”

Alcohol or other substances are the first-leading cause of death for people under 50. According to the Washington Post, the Center for Disease Control “has calculated that suicides from opioid overdoses nearly doubled between 1999 and 2014, and data from a 2014 national survey showed that individuals addicted to prescription opioids had a 40 percent to 60 percent higher risk of suicidal ideation. Habitual users of opioids were twice as likely to attempt suicide as people who did not use them.”

Joshua Gordon, director of the National Institute of Mental Health, said that undiagnosed or unreported mental illnesses played a role in suicide attempts. He explained, “When you do a psychological autopsy and go and look carefully at medical records and talk to family members of the victims, 90 percent will have evidence of a mental health condition.”

That indicates a large portion weren’t diagnosed, “which suggests to me that they’re not getting the help they need,” he said.

Stigma and shame prevent many people from seeking help for any kind of mental illness. People with substance use disorder are at higher risk for self-injury. Demanding that people with SUD receive equal respect, care, and support as people with other types of chronic mental health conditions, is key to breaking the cycle and saving lives.

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