Key Takeaways
Suicide Remains a Public Health Threat
- Suicide remains one of the ten leading causes of death in the United States.
- Suicide is complicated and tragic, but it is often preventable.
- In 2020 over 45,000 Americans died by suicide.
- Approximately 1.2 million Americans attempted suicide in 2020.
Substance Use Continues to Take Lives
- Overdose remains a leading cause of death as an unintentional injury.
- At the end of April 2021, there were over 100,000 drug overdose deaths in the United States.
- An estimated 40.3 million people have a substance use disorder.
- 5 million Americans used tobacco, alcohol, or an illicit drug in the past month.
Both substance use disorders and suicide are preventable for the most part. Prevention campaigns are life-saving. Addicted.org advocates for these campaigns and has witnessed their success. In addition, we firmly believe substance use prevention is suicide prevention. These two public health problems are closely linked, and here are four significant reasons why. But first, a closer look at suicide in the United States.
A Closer Look at Suicide in the U.S.
Approximately 93% of adults surveyed in the United States think that suicide can be prevented.
Preventing suicide involves looking at some of the contributing factors, but here are the numbers to paint a picture.
According to the American Foundation for Suicide Prevention:
- The age-adjusted suicide rate in 2020 was 13.48 per 100,000 individuals.
- The rate of suicide is highest in middle-aged white men.
- In 2020, men died by suicide 3.88x more than women.
- On average, there are 130 suicides per day.
- White males accounted for 69.68% of suicide deaths in 2020.
- In 2020, firearms accounted for 52.83% of all suicide deaths.
Age demographics include the following numbers per AFSP:
- In 2020, the suicide rates were higher among adults ages 25 to 34 years (18.35 per 100,000) and 75 to 84 years (18.43 per 100,000)
- The rate is highest among adults ages 85 years or older (20.86 per 100,000).
- Younger groups have had consistently lower suicide rates than middle-aged and older adults.
- In 2020, adolescents and young adults aged 15 to 24 had a suicide rate of 14.24 per 100,000.
The rates vary when it comes to suicide attempts, and there are differences depending on demographic characteristics such as age, gender, ethnicity, and race. There is no complete count of suicide attempts, yet data is gathered from hospitals.
The CDC provides the following:
- In 2020, an estimated 12.2 million American adults seriously thought about suicide.
- 2 million planned a suicide attempt.
- 2 million attempted suicide.
- In 2019, nonfatal self-harm cost the nation nearly $490 billion in medical costs, work loss costs, value of statistical life, and quality of life costs.
Overall, multiple factors influence suicidal behaviors. Here are four significant reasons why substance use is a leading factor that is linked to a substantial number of suicide attempts and suicides.
The Four Reasons
Alcohol is the Worst Depressant on the Planet
It is well established that alcoholics have a high rate of suicide. According to SAMHSA:
- 22% of deaths by suicide in the United States involve alcohol intoxication.
- Acute alcohol intoxication is present in about 30-40 percent of suicide attempts.
Suicide is a leading cause of death among people who misuse alcohol. Among that 22%, the blood alcohol level was well above the legal limit.
Alcohol is a catalyst for suicide because of the following behavioral mechanisms:
- Increase in psychological distress
- An increase in aggressiveness
- It propels suicidal ideation into action through suicide specific alcohol expectancies (it supplies motivation)
- It constricts cognition, which impairs the generation and implementation of alternative coping strategies.
Overall, a primary reason alcohol use significantly affects suicide rates is the disinhibition that occurs when a person is intoxicated. Older surveillance data has shown that alcohol misuse or dependence is associated with a suicide risk that is ten times greater than the suicide risk in the general population.
Substance Use and Suicidal Ideation are Connected
According to the National Survey of Drug Use and Mental Health, among adults aged 18 or older in 2020:
- 9% or 12.2 million people had serious thoughts of suicide.
- 2 million people made a suicide plan.
- 2 million people attempted suicide.
Substance use disorders in 2020 varied by age; the percentage was highest among young adults:
- 4% or 8.2 million young adults aged 18 to 24 had a substance use disorder
- 14% of 30.5 million adults aged 26 and older
- 3% or 1.6 million adolescents aged 12 to 17
Also, in 2020:
- 1 million people initiated alcohol use
- There also were 2.8 million new marijuana users
- 2 million new misusers of prescription pain relievers
During the COVID 19 pandemic, a survey was done to assess mental health, substance use, and suicidal ideation among adults aged 18 and older. The following results were discovered:
- 3% reported having started or increased substance use to cope.
- 9% of respondents reported at least one adverse mental or behavioral health condition.
- 3% reported trauma- and stressor-related disorder (TSRD) symptoms related to the pandemic.
- 7% reported they seriously considered suicide.
Alcohol and drugs are leading risk factors for suicide ideation. Substance addiction increases a person’s risk of facing life-changing consequences. In addition, it creates severe mental health issues. Overall, an individual loses their purpose while addicted to drugs or alcohol. Unfortunately, this creates motivation for suicide ideation.
Drug Addiction Increases the Risk for Suicide Attempts
As mentioned above, the subjective state of hopelessness is key to the disposition to actual suicides. Drugs and addiction are influential in providing a feeling of hopelessness.
These substances and their toxic effects manipulate neurotransmitters responsible for mood and judgment. In addition, illicit drugs disrupt interpersonal relationships and social support systems.
According to studies looking at suicide risk associated with drug and alcohol dependence:
- 50% of all suicides are associated with alcohol and drug dependence.
- 25% of alcoholics and drug addicts commit suicide.
- 70% of adolescent suicides may be complicated by drug and alcohol use and dependence.
Identifying alcohol and drug use and dependence is critical to assessing and preventing suicide.
Opioids and Alcohol are Associated with the Greatest Risk of Suicidal Behavior
According to the CDC, overdose deaths from opioids increased to 75,673 in the 12 months ending in April 2021, up from 56,064.
The nation’s opioid crisis is a significant component of suicide deaths. Experts still do not know precisely how many opioid overdose deaths are actually suicides. Yet, it is estimated that 30% fit this description.
The statistics are staggering:
- People who misused prescription opioids were 40-60% more likely to have thoughts of suicide.
- People with a prescription opioid use disorder were also twice as likely to attempt suicide.
- Opioid-related suicides have doubled in the last 15 years.
- Increased opioid dose was related to an increased risk of suicide.
Data has shown that the connection between opioid overdose and suicide has increased over time. Data collected from 1999 to 2014 shows that suicides involving opioids among all age groups, except teens, have quadrupled.
On a Brighter Note, Prevention is Working, and Suicide Rates are Changing
The CDC examined suicide rates from 2019 to 2020 by race/ethnicity, age, mechanism of injury, county urbanization level, sex, and state.
In 2020, a total of 45,979 deaths were attributable to suicide, a decrease of 1,532 from 47,511 suicide deaths in 2019.
From 2019 to 2020, the overall suicide rate declined significantly by 3.0% (from 13.9 to 13.5 per 100,000 population).
The overall suicide rate declined significantly from 2019 to 2020 in seven states (California, Connecticut, Florida, New Jersey, Ohio, Oregon, and Pennsylvania) (Figure 2). It remained stable in all other states and the District of Columbia.
What Can We Do to Prevent Suicide?
Know the 12 suicide warning signs, which are closely related to some behavioral signs of addiction.
- Feeling like a burden
- Being isolated
- Increased anxiety
- Feeling trapped or in unbearable pain
- Increased substance use
- Looking for a way to access lethal means
- Increased anger or rage
- Extreme mood swings
- Expressing hopelessness
- Sleeping too little or too much
- Talking or posting about wanting to die
- Making plans for suicide
Recognize substance use as a major contributing factor. Drug addiction and alcoholism often go unnoticed until it is too late.
Common signs of addiction include:
- Changes in social groups, new and unusual friends, odd phone conversations
- Drug paraphernalia such as unusual pipes, cigarette papers, small weighing scales, etc.
- Financial problems
- Lying, secretiveness, and stealing
- Repeated unexplained outings, often with a sense of urgency
- “Stashes” of drugs, often in small plastic, paper, or foil packages
Familiarize yourself with the five action steps for helping someone in emotional pain.
- ASK: “Are you thinking about killing yourself?”
- KEEP THEM SAFE: Reducing a suicidal person’s access to highly lethal items or places.
- BE THERE: Listen carefully and learn what the individual is thinking and feeling.
- HELP THEM CONNECT: Save the National Suicide Prevention Lifeline’s (1-800-273-TALK (8255)) and the Crisis Text Line’s number (741741) on your phone.
- STAY CONNECTED: Staying in touch after a crisis or after being discharged from care can make a difference.
Know the resources available to you.
National Suicide Prevention Lifeline at 1-800-273-8255. This hotline is available 24/7, 365 days a year.
It has a separate hotline for Spanish-speaking callers available at 1-888-628-9454.
If you are deaf or hard-of-hearing, you can chat with a Lifeline counselor 24/7 via the following options:
- Online chat by clicking the chat button on this website.
- Video relay service by calling 1-800-273-8255.
- TTY by calling 1-800-799-4889.
- Voice/Caption Phone by calling 800-273-8255.
Veterans Crisis Line at 1-800-273-8255. You may also text 838255 or chat online through their website. If you are deaf or hard-of-hearing, call 1-800-799-4889. Their services are available to all veterans, service members, members of the National Guard and Reserve, and their family members and friends.
Crisis Text Line by texting 741741. Services are offered 24/7, and you will usually be connected with a trained crisis volunteer within 5 minutes.