Facts: Substance Abuse and Suicide (Massachusetts Version)

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© 2015 Unified Community Solutions. All Rights Reserved. Updated 06/05/2015.
Permission granted for non-commercial use: UCS logo and copyright must be included.
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FACTS: SUICIDE AND SUBSTANCE ABUSE
1. Substance abuse and lifetime risk of suicide:
! Lifetime risk has not been accurately quantified, e.g., Sher (2006) reported
a range of about 3% to 18%.
! There is also a range among current fatalities:
• 15% to 56% of suicides had alcohol dependence or abuse
(Yoshimasu, Kiyohara, & Miyashita, 2008)
• 10% to 69% of suicides had acute alcohol use (Cherpitel, Borges, &
Wilcox, 2004)
• 25% of suicides had alcohol abuse disorders (CSAT, 2008)
(These data indicate that the lifetime risk of suicide for people with alcohol depen-
dence or abuse is relatively high, even if the exact percentage is not known.)
2. Substance abuse disorders implicated in suicide attempts:
! Individuals with substance use disorders at increased risk for suicidal
ideation and attempts (Kessler, Borges, & Walters, 1999)
! Risk of suicide attempts 6.2 times greater than average (Molnar, Berkman,
& Buka, 2001)
! 132,500 visits to emergency rooms in 2005 for alcohol- or drug-related
suicide attempts; 85 percent admitted to a hospital or healthcare facility
(SAMHSA, 2007)
3. Acute substance use and suicide:
! Present in 30% to 40% of attempts and suicides (Cherpitel, Borges, &
Wilcox, 2004)
! Prevalence of intense, short-lived depression in people seeking treatment
for cocaine, methamphetamine, and alcohol abuse (Brown et al., 1995;
Cornelius et al., 1996; Husband et al., 1996)
! Causes increased disinhibition; inordinate focus on current situation, not
on consequences; depressed mood (Hufford, 2001)
! Promotes depression and hopelessness; impairs problem solving; and
facilitates aggression (Conner and Chiapella, 2004)
4. Substance use disorders and suicide:
! Suicide a leading cause of death for people who abuse alcohol and drugs
(Wilcox et al., 2004)
! Individuals treated for abuse/dependence at 10 times greater risk for
suicide; people who inject drugs 14 times greater (Wilcox et al., 2004)
! Alcohol found in one-third of suicide victims tested; four other substances
found in 10 percent of victims (CSAT, 2008)
! People seek treatment at times when difficulties are at their peak (CSAT,
2009)

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0
10
20
30
40
50
60
70
Current
depressed
mood *
Current
mental
health
problem *
Current
mental
health
treatment *
Disclosed
intent
Alcohol
dependence
*
Physical
health
problem *
Percentage
Male
Female
! Increased risk for suicide after discharge from inpatient psychiatric units,
emergency departments, and residential addiction treatment (U.S.
Department of Health and Human Services, 2012)
! In Massachusetts in 2011, 27% of suicide victims had an alcohol or other
substance use problem (Massachusetts Dept. of Public Health, 2014).
5. Toxicology findings for suicide fatalities (McKeon, 2013):
! Alcohol: Tested in 72% of decedents:
• 32% were positive for alcohol (62% BAC > .08mg/DL)
! Other substances/medications:
• Antidepressants (tested in 40%, present in 25%)
• Opiates (tested in 48%, present in 19%)
• Cocaine (tested in 48%, present in 9%)
• Marijuana (tested in 36% , present in 8%)
• Amphetamines (tested in 42%, present in 5%)
• Other drug (tested in 43%, present in 49%)
6. Suicide decedents aged 20-64 years by sex (McKeon, 2013):
7. Substance use and mood disorders:
! Alcohol/drug abuse second only to mood disorders as most frequent
suicide risk factor (CSAT, 2008)
! 90 percent of suicide fatalities involve a mental or substance use disorder
(25 percent involve alcohol abuse disorders) (CSAT, 2008)
! Depression is a common co-occurring diagnosis (other mental disorders
are also implicated) (Conner et al., 2007; Murphy et al., 1992; Roy, 2001,
2002)

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8. Effects of socio-economics:
! Suicide risk is increased by (Wyllie et al., 2012):
• Unemployment
• Low income
• Socio-economic deprivation
• Economic recession
! “Since the rate of unemployment between 2007 and 2010 in the USA
increased from 5.8% to 9.6%, our model indicates that the rise in U.S.
unemployment during the recession is associated with a 3.8% increase in
the suicide rate ... [which] could account for about a quarter of the excess
suicides noted in the USA during this time” (Reeves et al., 2012, p. 1813).
9. Yoshimasu and colleagues (2008) highlight the connection among
substance abuse, depression, unemployment, and broken relationships, calling
the interaction among them a "vicious circle" (p. 253).
10. Men and substance abuse:
a. In the United States in 2013, 78% of suicide fatalities were men (CDC).
Also, according to SAMHSA (2009):
! Males twice as likely to be classified with substance abuse-dependence
as females (age 12 and older)
! They are more than twice as likely to receive treatment for an AOD
problem in past year.
b. In Massachusetts in 2013 (CDC):
! 73% of suicide fatalities were men.
! The highest rate of suicide was among men 40-44 years old (18.92/100K).

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© 2015 Unified Community Solutions. All Rights Reserved. Updated 06/05/2015.
Permission granted for non-commercial use: UCS logo and copyright must be included.
Download free at bit.ly/ssafacts. Contact UCS at bit.ly/homeucs.
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