Does Alcohol and Other Drugs Increase the Risk of Suicide?

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Suicide is one of the leading causes of death in America, and has tragically risen by 35% in the past twenty years. Depression and other mood disorders are the primary causes of suicide, but many people are not aware of the strong links between drugs and alcohol use and suicide.

Yes, Drug and Alcohol Use Can Increase Suicide Risk

The truth is that alcohol and drug use can put you at a higher risk of dying by suicide. While this is distressing news, knowledge is power. Effective treatment is available for both suicide ideation and substance use and abuse. There is hope for a happier and healthier future.

Read on for what to know about the connection between substance usage and suicide, in what ways using drugs and alcohol increases your risk—and most importantly, how to get help for both your substance use issues and mental health concerns.

Crisis Support

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

Prevalence of Suicide

In any given year, about 44,000 people will die of suicide, which amounts to approximately 121 suicides per day. The vast majority of people who die by suicide—at least 90%—are battling a psychiatric disorder. But a large number of people who die by suicide also might be using substances or alcohol. In fact, people who have alcohol or drug abuse disorders are 10 to 14 times more likely to die by suicide.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA):

  • 22% of suicides involve alcohol inebriation
  • Opiates (prescription painkillers and heroin) are found in 20% of deaths involving suicide
  • Marijuana use is present in 10.2% of suicides
  • Cocaine use in a factor in 4.6% of suicides
  • Amphetamine usage is found in 3.4% of suicides

In addition to deaths, alcohol is a factor in suicide attempts, with 30% to 40% of suicide attempts involving alcohol intoxication. In addition, suicide attempts land about 650,000 people in emergency rooms in any given year.

How Alcohol and Drugs Increase Suicide Risk

There are several different ways that alcohol and drug use increases suicidal thoughts and behaviors. Research shows that substance abuse in and of itself can increase these risks, especially among those who engage in chronic substance use.

Some of the ways that substance use increases suicidal risk include:

  • Reductions in sound judgment and impulse control
  • Drugs and alcohol can disrupt neurotransmitter pathways, resulting in inhibition loss
  • Substance misuse can lead to neurological damage and serious medical complications, which can increase the risk of psychiatric diseases linked to suicide

Different substances may have varied effects on the body, and create unique suicide risks. Drugs can have stimulant effects, depressing effects, or a combination of both. For example:

  • Stimulants (cocaine, amphetamines) can lead to decreased inhibitions, erratic behavior, and impulsiveness, all of which increase the risk of suicidal behaviors
  • Depressants (alcohol, opiates) may be linked to the feelings of hopelessness and depression common among people with suicidal behaviors

Additionally, people who are contemplating suicide may believe that being under the influence of drugs or alcohol during a suicide attempt will decrease pain or make them more likely to follow through. Substance abuse also reduces the chance that a person will be able to use their cognitive skills to consider alternatives to suicide or to think clearly enough to reach out for mental health support.

Other Risk Factors for Suicide

Substance abuse alone can increase your risk of suicide. Still, in most cases, people who use substances and die by suicide experience co-morbid psychiatric conditions. In addition, age and other socioeconomic determinants may increase risk.

People who have psychiatric disorders along with substance use disorders are at a higher risk of suicide.

Here’s what to know:

  • People at highest risk are those with bipolar disorder and clinical depression
  • Schizophrenia and anxiety disorder also increases the risk
  • Males with both depression and alcoholism have the highest risk of suicide
  • People who have bipolar disorder and alcohol use disorder have a 21% to 42% increased risk of suicide attempts
  • People who have both bipolar disorder and substance use disorder have an increased risk of suicide attempts in comparison to people who experience bipolar disorder only

Certain individuals who have substance use issues may be at increased risk of suicide:

  • Young people with substance use issues are at higher risk of suicide
  • Among American and Alaskan native people, a combination of alcohol and depression is the most prevalent risk factor for suicide
  • Depression, social problems, and financial issues along with substance use issues increase suicide risk
  • People who are generally prone to impulsive behavior and who use drugs or alcohol are at an increased risk of suicide

Getting Help

When it comes to preventing suicide, a multi-factorial approach works best. Addressing psychiatric conditions, social conditions, and life circumstances, along with any substance use issues, is vital when it comes to decreasing the risk of suicide.

First, it’s important to understand and recognize the signs of suicide ideation, as well as substance use.

Some warning signs may include:

  • Increased use of drugs and alcohol
  • Isolating oneself from family and friends
  • Feeling detached, without hope, or numb
  • Noticeable changes in sleeping and eating
  • Intense mood wings
  • Uptick in risky and impulsive behaviors
  • Giving away or donating your personal items
  • Sharing thoughts of wanting to die, or wanting to be gone from life
  • Making active plans for dying by suicide

If these warning signs apply to you or someone you know, get help as soon as possible, particularly if the behavior is new or has increased recently. All too often, people who die by suicide have been showing warning signs, but they may not have been taken seriously. Therapy, psychiatric care, and medications can help address any psychiatric conditions that are contributing.

People who experience substance use or misuse may find substance use counseling helpful. Others may require in-patient care at a substance abuse treatment center. You can go to findtreatment.gov to find a substance abuse treatment center near you.

At other times, it may be important for you or your loved one to seek emergency care for suicide. If you or your loved one is at immediate risk of self-harm or suicide, there is effective and confidential care available to you.

A Word From Verywell

Suicide is something that affects people from all walks of life and is something that must be taken seriously. Substance use among people who die by suicide is more prevalent than most realize, and it’s important to understand the connection between the two. The good news is that suicide and substance use disorders are preventable, and there are many treatment options out there to address both suicidal ideation and substance use.

Please don’t hesitate to reach out for help if you or a loved one is experiencing these challenges. Hope is out there, and your life is important.

9 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Rizk MM, Herzog S, Dugad S, et al. Suicide Risk and Addiction: The Impact of Alcohol and Opioid Use Disorders. Current Addiction Reports. 2021;8:194–207. doi:10.1007/s40429-021-00361-z

  2. Esang M, Ahmed S. A Closer Look at Substance Use and Suicide. Psychiatry. 2018;13(6):6-8. doi:10.1176/appi.ajp-rj.2018.130603

  3. Substance Abuse and Mental Health Services Administration. Substance Abuse and Suicide: A Nexus Requiring a Public Health Approach.

  4. Substance Abuse and Mental Health Services Administration. Substance Abuse and Suicide: A Nexus Requiring a Public Health Approach.

  5. Orpana H, Giesbrecht N, Hajee A, et al. Alcohol and other drugs in suicide in Canada: opportunities to support prevention through enhanced monitoring. Injury Prevention. 2020;27(2):194-200. doi:10.1136/injuryprev-2019-043504

  6. Lynch FL, Peterson EL, Lu CY, et al. Substance use disorders and risk of suicide in a general US population: a case control study. Addiction Science and Clinical Practice. 2020;15(14). doi:10.1186/s13722-020-0181-1

  7. U.S. Department of Health & Human Services. Does alcohol and other drug abuse increase the risk for suicide?

  8. National Institute of Mental Health. Warning Signs of Suicide.

  9. Lynch FL, Peterson EL, Lu CY, et al. Substance use disorders and risk of suicide in a general US population: a case control study. Addiction Science and Clinical Practice. 2020;15(14). doi:10.1186/s13722-020-0181-1

By Wendy Wisner
Wendy Wisner is a health and parenting writer, lactation consultant (IBCLC), and mom to two awesome sons.