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Understanding How Substance Use is Connected to Suicide

Marcel Gemme By Marcel Gemme | Last Updated: 19 September 2023
  • What You'll Learn

Prevention Efforts Save Lives

It is no secret that America has a drug problem. This would better be defined as a substance use problem since it includes alcohol, the nation’s most popular drug. But one subject that is often overshadowed and even obscured by our addiction epidemic is the growing issue of suicide. The two problems can often be intertwined, with no clear answer for one without solving the other. And unfortunately, these are issues that have become extremely common among our youth, particularly in postsecondary educational settings like colleges, universities, and vocational schools.  

Adolescence and young adult life are critical times for preventing addiction. The early use of drugs increases a person’s chances of becoming addicted. In addition, drug use changes how the brain functions, leading to addiction and other serious mental health issues that can include suicidal ideation. Without early intervention and prevention efforts, substance use and suicidal ideation can become serious issues that may pervade adult life.

Substance use prevention alone has been shown to reduce the risk of suicide. But suicide prevention, as its own field, is also crucial. During transitional periods, adolescents and young adults are at an increased risk of mental health issues like substance use and suicide. There is even a link between substance use and suicide among young adults during these transformative years. The pressures of college and university, finding employment, the expectations created by parents and institutions, and the influence of peers can significantly increase stress.

This is where many people discover that drugs and alcohol can be misused to cope with stress. However, underlying mental health issues can be exacerbated by substance use. Or, new mental health issues can develop, including suicidal ideation. Drug education and prevention are essential aspects of suicide prevention efforts and can pave the way for overcoming stigma and making support and help readily available. 

The Link Between Substance Use and Suicide

There are significant risk factors that can lead to drug addiction. These include behaviors like early first-time substance use and regular use of substances throughout the teen years. Other factors include growing up in an environment where drug use is common or acceptable and experiencing trauma or extreme loss. Some of the risk factors of suicide overlap these.

They include:

  • Depression
  • Feeling hopeless 
  • Trauma
  • Extreme or unexpected loss
  • Financial distress
  • Family history of suicide

In addition, many young people who experience drug addiction and suicidal ideation are struggling with other mental health issues.

Depression, substance use, and aggressive behavior disorders are among the most influential risk factors for suicide among adolescents and adults. Evidence has shown that adolescents who use drugs are at an increased risk of suicidal ideation, attempted suicide, and completed suicide. According to the Substance Abuse and Mental Health Services Administration, nearly one in twelve adults in the United States who committed suicide had a substance use disorder. In addition, opiates, including heroin and prescription pain medication, are present in 20% of suicide deaths in the United States. This disparity indicates that some of these people either had an undiagnosed substance use disorder or were not addicted to drugs but took them shortly before death.  

Research has shown that the number of substances used seems to be more predictive of suicide than the type of substance used. Additionally, 22% of deaths by suicide in the United States involve alcohol intoxication. Alcohol or drug misuse significantly affects suicide rates because of the disinhibition that occurs when a person is intoxicated.

Illicit and licit drugs are used for different reasons. After high school, many students begin to experiment with different substances. They may be coping with external pressure while attending college or vocational school. The inability to manage external pressure and stress is one reason why many students experiment with drugs or binge drink. Unfortunately, suicidal ideation often follows as the pressure builds and the person sees no way out of addiction or the looming consequences of avoidance. More and more drugs are used to try and cope, and eventually, they discover that the drugs have made them unable to manage their negative thoughts and feelings towards life. This is when tragedy can occur.

Suicide is among the top three leading causes of death in young adults.

Suicide Rates Among Young Adults

According to the Centers for Disease Control, national suicide rates among persons aged 10 to 24 didn’t change much from 2000 to 2007. However, in 2007 it increased by 57.4%. Overall, from 2007 to 2018, suicide rates for this age group increased significantly in 42 of America’s states, with most states seeing somewhere between a 30% and 60% increase. Sadly, youth suicide has become an increasingly prominent public health issue.

The American Foundation for Suicide Prevention has stated that suicide is the 10th leading cause of death in the United States. In 2019, adolescents and young adults aged 15 to 24 had a suicide rate of 13.95 per 100,000. And while suicide rates for young adults have historically been lower than that of adults, since 2010, there has been a steady increase in the number of college and university students who received mental health services after considering suicide. And most recently, between 2019 and 2020, 36.9% of college and university students fell into this category.

According to the National Institute on Mental Health, suicide was the second leading cause of death among individuals between the ages of 10 and 34 in 2019. Among those aged 15 to 24, unintentional injury was the leading cause of death, followed by suicide. And when we examine adults across all age groups, the prevalence of serious suicidal thoughts was highest among those aged 18 to 25. These factors all point toward a serious and growing problem. 

The External Pressure of College

Anyone observing a college or vocational school student can see that this is a phase of life where young adults are confronted with expectations—for example, new relationships, living situations, financial responsibilities, and planning for the future. Some stress cannot be prevented, and some of it is expected. Having a plan and support is essential. External pressure and stress left unhandled can easily lead to substance use, mental health issues, and suicidal ideation. Drugs and alcohol are unhealthy ways of alleviating this stress.

According to the Association of American Universities, stressful life events were high among college students. And these stressful events were associated with mental health issues. Approximately three out of four students reported having experienced at least one stressful life event last year. And roughly 20% of students reported experiencing six or more stressful life events in the last year. The data pointed out that mental health diagnoses and suicidality were common, and rates of troublesome mental health symptoms among college students are increasing. Substance use is among the most critical problem facing these students. Research has indicated that roughly 26% of male and 19% of female full-time college students use illicit drugs.

Peer influence and stress are significant factors that contribute to substance use among college students. In addition, numerous individual-level characteristics affect substance use behavior. Addiction is often also associated with more severe disorders that tend to be chronic and place the individual at a higher risk for suicide. These issues, coupled with the external pressure of success, are not easy to manage.

The first step in prevention is noticing the indicators of stress. Feeling lost or alone, unable to sleep or eat, and forcing a happy face are clear signs that support is needed. It is common for students to be pressured and, as a result, become less motivated, procrastinate, and not looking forward to anything. During this time, the individual may seem to be functioning even though they are struggling and are worried. Despite the effort to handle things independently, they may not be able to manage their academic workload along with everything else. Not reaching out for help and internalizing the problems increases the risk of substance use and suicide.

There is a strong association between acute and chronic stress and the motivation to misuse licit or illicit drugs. For example, psychological models of addiction view drug use as coping strategies to deal with stress. In addition to this, it is a way to reduce tension, self-medicate, and decrease withdrawal-related symptoms. Unfortunately, considerable evidence now shows that adolescents and young adults facing recent negative life events have increased levels of drug use.

Preventing Substance Use Can Prevent Suicide

Not all suicide attempts are connected to substance use. But according to studies, over 50% of all suicides are associated with alcohol and drug dependence, and 25% of individuals addicted to drugs and alcohol commit suicide. In addition, over 70% of adolescent suicides are complicated by drug and alcohol use and dependence. Thus, prevention and education regarding drug use can make a considerable impact on preventing suicide. Prevention programs enhance protective factors and reverse or reduce risk factors. In addition, prevention programs aimed at general populations during key transition points in life produce beneficial effects. Preventing drug use is a part of suicide prevention because if someone does not become addicted to drugs, it reduces their risk of suicide.

Suicide is preventable, yet it is underreported because of the stigma associated with it. In addition, nonfatal suicidal behavior or attempts to takes one’s life are often overlooked because the individual may never talk about it. But working to stop something from happening is easier than having to try and resolve it later. Drug use and suicide prevention efforts are never a waste of time or resources. There are numerous organizations, tips, and support services for young adults who are struggling.

Reaching Out for Help and Support

Preventing substance use and suicide is a serious matter that will require a collective effort. Prevention activities aim to educate and support individuals and communities by giving people knowledge and resources to better themselves. But even simply being more aware of the subject can bring about positive change. 

Common warning signs of early substance use include: 

  • deteriorating academic performance
  • depression
  • dramatic mood changes
  • hopelessness
  • preoccupation with death
  • anxiety
  • agitation
  • uncontrolled anger
  • engaging in risky activities
  • withdrawing from friends and family
  • neglecting appearance
  • increased alcohol and drug use
  • giving away prized possessions

If one observes these behaviors, begin by asking the person questions. Don’t be fearful of inquiring about suicidal thoughts or excessive drug or alcohol use. 

Most suicidal persons want to live but are unable to see an alternative to their current situation. They usually give warnings of their intentions, whether subtle or direct, but those around them are either oblivious or don’t know how to respond. Examples of these signs can manifest themselves differently, but paying attention to how a person speaks is essential. 

Be aware if a person talks about:

  • Killing themselves
  • Feeling hopeless
  • Having no reason to live
  • Being a burden to others
  • Feeling trapped
  • Unbearable pain
  • Wishing they weren’t alive
  • How everyone would be better off without them

This type of talk can be indicative of suicidal thoughts, and it is vital to speak to someone if these warning signs are present.

Talking about suicide does not cause someone to be suicidal. Conversely, if a person talks about suicide or expresses their feelings, it does not mean they are now no longer at risk. Most suicide attempts are an expression of extreme distress, not harmless bids for attention. The best way to help anyone struggling with drug addiction or suicide is to show interest in helping them and be supportive. 

Be direct and ask them if they are considering suicide or have a plan. At the same time, do not be judgmental, give advice, or argue with them. Do not swear to secrecy, but offer hope that alternatives are available. Finally, please do not leave the person alone; take action by getting them the help they need.

Resources for Suicide Prevention

If someone you know is showing signs they may be suicidal, be supportive and get them to professional help immediately. The following are resources that can be useful during this difficult time.

National Suicide Prevention Lifeline
By calling 1-800-273-TALK (8255) you will be connected to a skilled, trained counselor at a crisis center in your area, anytime 24/7.

American Foundation for Suicide Prevention
The nation’s leading organization bringing together people across communities and backgrounds to understand and prevent suicide and to help heal the pain it causes.

An Online Crisis Network. The first online network with 100% of its volunteers trained and certified in crisis intervention.

The Jed Foundation
As the nation’s leading organization working to promote emotional health and prevent suicide among college students, The Jed Foundation protects students’ mental health across the country.

An online resource for college mental health. It also includes a helpline for those with more serious mental health issues such as suicidal thoughts and how to help a friend.




More Information

Marcel Gemme has been helping people struggling with addiction for over 19 years. He first started as an intake counselor for a drug rehabilitation center in 2000. During his 5 years as an intake counselor, he helped many addicts get the treatment they needed. He also dealt with the families and friends of those people; he saw first-hand how much strain addiction puts on a family and how it can tear relationships apart. With drug and alcohol problems constantly on the rise in the United States and Canada, he decided to use the Internet as a way to educate and help many more people in both those countries. This was 15 years ago. Since then, Marcel has built two of the largest websites in the U.S. and Canada which reach and help millions of people each year. He is an author and a leader in the field of drug and alcohol addiction. His main focus is threefold: education, prevention and rehabilitation. To this day, he still strives to be at the forefront of technology in order to help more and more people. He is a Licensed Drug and Alcohol Treatment Specialist graduate with Honours of Stratford Career Institute. Marcel has also received a certificate from Harvard for completing a course entitled The Opioid Crisis in America and a certificate from The University of Adelaide for completing a course entitled AddictionX: Managing Addiction: A Framework for Succesful Treatment.