Substance Abuse and Suicide

A recent study published in the Nov. 26 issue of the journal Drug and Alcohol Dependence, Cocaine users twice as likely to become suicidal, that followed users of injectable drugs over a seven-year period found that “users of cocaine and amphetamines were roughly twice as likely to attempt suicide than users of opiates, sedative-hypnotics, cannabis and alcohol.”

Noting that:

…users of cocaine and amphetamines have personality traits that make them generally more impulsive and more subject to mood swings, and the drugs themselves also cause mood swings and impulsive behaviour.

See also:

New research from the University of Montreal and the CHUM Research Center suggest that people who use stimulants such as cocaine and amphetamine have a nearly two-fold greater likelihood of suicidal behavior amongst people who inject drugs.


The data available until recently did not allow identifying the substance use patterns most at risk. We wanted to know who among substance users were actually more likely to attempt suicide,” researcher Didier Jutras-Aswad said in a statement.


Several substances were evaluated in detail, including cocaine, amphetamines, opioids, cannabis, alcohol, and sedative-hypnotics available illegally on the street (i.e., barbiturates and benzodiazepines).

The findings indicate that suicide attempts are most common among people who inject drugs. But researchers also found that chronic and occasional use of stimulant drugs such as cocaine and amphetamines was associated with nearly two-fold greater odds of reporting an attempt than the use of other drugs to report a suicide attempt.

They did not observe the same positive association with other substances, including opiates, which are nevertheless regarded as among the most damaging to health and psycho-social wellbeing.

From Psychiatric Times:

Although it is difficult to compare the relative impact among different mental health problems with the risk of suicide, alcohol and drug use disorders have been found to be strongly related to suicide risk. Individuals with a substance use disorder (ie, either a diagnosis of abuse or dependence on alcohol or drugs) are almost 6 times more likely to report a lifetime suicide attempt than those without a substance use disorder. Numerous studies of individuals in drug and alcohol treatment show that past suicide attempts and current suicidal thoughts are common. Recent evidence from veterans indicates that men with a substance use disorder are approximately 2.3 times more likely to die by suicide than those who are not substance abusers. Among women, a substance use disorder increases the risk of suicide 6.5-fold.

Violence towards others and violence towards inwards:

The tendency to engage in violent behavior is a potentially important risk factor for suicide in substance abusers. Up to 75% of those who begin addiction treatment report having engaged in violent behavior (e.g. physical assault, mugging, attacking others with a weapon).  Emerging research also indicates that violence may partially account for the connection between substance abuse and suicide risk. For example, in those seeking treatment for substance use disorders, the perception that they have difficulty in controlling their own violent behavior was associated with a greater likelihood of a prior suicide attempt. Tiet and colleagues hypothesized that individuals who have difficulty in controlling their anger may be more likely to act impulsively, thus turning the violence on themselves rather than on others.

Individuals with alcohol use disorders and prior aggressive behavior are more likely to report suicidal thoughts or past suicide attempts. In one recent study of more than 6000 adults who began addictions treatment, those who had committed serious violent acts (e.g. rape, murder, assault resulting in serious injury) were more than twice as likely to report multiple suicide attempts. This finding held true even after statistically controlling for demographic characteristics, depression, and past victimization.

Another study compared accident victims with individuals who completed suicide. Violent behavior in an individual’s last year of life was linked to a higher likelihood of suicide, even when controlling for alcohol use disorders and other potential suicide risk factors.

An association exists between substance use disorders and suicidal behavior It is imperative to consider other factors including culture, race, sex, age, type of substance use and history, history of violence, and host of mental health factors and past behavior.


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