Problem drinking linked to increased risk of suicide attempt and self-harm University College London

In addition, easy access to a variety of clinical and nonpharmacological interventions can be helpful. These interventions may include psychotherapy, motivational interviewing, cultural and family engagement, fostering spiritual beliefs, and limiting access to alcohol at the community level. Additionally, clinicians should address coexisting smoking addiction, because people with psychiatric symptoms of alcohol withdrawal disorders often have a truncated life span due to smoking related diseases and premature mortality, compared with the general population. Furthermore, nicotine use has been shown to contribute to deaths by suicide (18, 22). Patients who are reluctant to adopt pharmacological recommendations should be referred for nonpharmacological treatment modalities as described above.

  1. Whether a close personal relationship or that of a friend, suicide claims the lives of thousands each year.
  2. What is less clear is the role that alcohol plays in the events leading up to an act of suicide.
  3. Baseline assessments included the Alcohol Use Disorders Identification Test to quantify alcohol consumption and resulting problems, and measures of depression, suicidal ideation and suicidal behavior.
  4. Depression is a common and serious mood disorder, which can impact your thoughts, feelings, and behaviors.
  5. While the prevalence and destructiveness of suicide is clear, much less is known about why people die by suicide.

Alcohol-Related Risk of Suicidal Ideation, Suicide Attempt, and Completed Suicide: A Meta-Analysis

The studies reporting suicide as a general term without distinguishing between suicidal ideation, suicide attempt, or completed suicide were excluded. The supporting PRISMA checklist of this review is available as supporting information; see S1 PRISMA Checklist. The observational studies addressing suicide rate among alcohol abusers without comparison group or self-harm without suicide intention were excluded. Suicide is one of the top 20 leading causes of death in the world for all ages [1], the third leading cause of death among people aged 15–44 years, and the second leading cause of death among people aged 10–24 years [2].

The Alcohol-Suicide Link: A Bond Difficult to Disentangle

In many cases, the physical illness itself, and medications adopted to treat it, may cause depressive symptoms. Complicated or traumatic grief, anxiety, unremitting hopelessness after recovery from a depressive episode, and a history of previous suicide attempts are risk factors for attempted and completed suicide. Overt suicidal behavior and indirect self-destructive behaviors, which often lead to premature death, are common, especially in residents of nursing homes, where more immediate means to commit suicide are restricted. Reviewing the literature for the period 1991–2001, Cherpitel, Borges, and Wilcox [88] found a wide range of alcohol-positive cases for both completed suicide (10–69%) and suicide attempts (10–73%).

Statistical analysis

Yet, no prospective studies have examined alcohol use patterns among college students as predictors of suicidal behaviors. A suicidal ideation is “thinking about, considering, or planning for suicide” [16]. A suicide attempt is “a non-fatal self-directed potentially injurious behavior with any intent to die as a result of the behavior” [16]. A completed suicide is “a death caused by self-directed injurious behavior with any intent to die as a result of the behavior” [16].

Studies of interventions to prevent the recurrence of suicidal behavior that are appropriate for different age and cultural groups are especially needed. Extending such research to non-traditional settings, for example, 12-step or peer-led programs, is another important direction that carries the potential for increased social support generally as well as more targeted support designed to prevent suicidal behavior. Even if someone does not fit all the criteria of an alcohol use disorder, they can still be at risk of developing alcohol dependence, putting their physical and mental health at risk due to alcohol abuse. Addressing alcoholism in a clinical setting and providing recommendations about setting limits or considering abstinence can help people make informed and conscientious decisions about their alcohol consumption. Excluding substance-induced psychotic disorders, the lifetime rate of substance use disorders in people with psychotic disorders is 62.5%. Alcoholism may cause acute paranoid-hallucinatory psychosis and, although prognosis is good, 10–20% of patients with alcohol psychosis will develop a chronic schizophrenia-like syndrome [243,244].

According to the evidence, their risk of suicide is never higher than it is in this case. Taking a closer look at family engagement as an intervention in substance use disorders, the clinician should engage the patient’s family and friends in forming a crisis plan. For example, a crisis plan for a person who abuses opioids should include education and naloxone, particularly for those with a high risk of reattempting suicide via opioid overdose. Such individuals include those taking high-dose prescription opiates for chronic pain, those recently discharged from the hospital for opioid intoxication or overdose, and those recently released from prison with a history of opioid use disorder (19).

Suicide is the second leading cause of death among college students (Turner et al., 2013), and this population has recently shown marked increases in rates of depression, suicidal ideation and suicide attempts. In particular, the Healthy Minds Survey showed a 157% increase in suicide attempts between 2011 and 2018 (Duffy et al., 2019). Moreover, students participating in a national survey in 2001–2002 were 1.25× more likely to meet DSM-IV criteria for an alcohol use disorder relative to an age-matched cohort not attending college (Blanco et al., 2008).

The studies with seven star-items or more were considered a low risk of bias and those with six star-items or fewer were considered a high risk of bias. The main bibliographic databases, including PubMed, Scopus, and Web of Science, were searched until February 2015. The reference lists of all included studies were scanned and the authors of the identified studies were contacted for additional eligible studies. The researchers say these findings suggest that alcohol use may have been a core driver in the accelerated increase in suicide among U.S. women.

They measured blood alcohol concentration among unintentional injury deaths as well as homicide and suicide cases and concluded that blood alcohol concentration was high among the victims. However, no pooled estimate of the association between suicide and AUD was reported. Another meta-analysis conducted by Fazel et al in 2008 [13] to estimate the alcohol-related risk of completed suicide in prisoners. The results of this meta-analysis was limited to a specific population which may not be generalized to the general population.

He hopes the process will help researchers quantify the prevalence of such language in clinical notes and identify patterns that can inform interventions. The team will also analyze the association of stigmatizing language with patient outcomes. Depending on the severity of the disorders, you may need more intense treatment, such as outpatient care, integrated assertive community (ACT) treatment or a residential stay, which may be required to begin or continue your recovery journey. “Therapeutic interventions designed to address both issues often include a focus on addressing emotional pain or trauma, as well as developing and practicing healthy coping behaviors,” says Kennedy.

His time-series analysis suggests a positive relationship between the level of vodka sales per capita and suicide rates with no time lag and at first degree lags. As a matter of fact, the almost contemporaneous association between the two time-trends may support the ecstasy withdrawal point that binge-drinking of strong spirits is a risk factor for autodestructive behavior. It is important to point out that the size of the bivariate association between the level of vodka sales and suicide rates for men is substantially greater than for women.

Although more research is needed to elucidate the link between alcohol use and suicide, the findings point to a need for more education and awareness of this relationship, as well as improved screening and intervention strategies. Heavy drinkers are five times more likely to attempt suicide than light or social drinkers, according to one study. Over three-quarters of Canadians drink alcohol, so either you drink or know someone who does. As Canadians weigh the pros and cons of adopting the new drinking guidelines, they should be thinking not just about the risks to their physical health, but also to their mental health. Public policies should be looking to increase awareness of the link between alcohol and suicide and to assess and treat problematic alcohol use as a way to prevent suicide.

The exposure of interest was AUD including alcohol abuse and alcohol dependence [14]. AUD is a condition characterized by the harmful consequences of recurrent alcohol use and physiological dependence on alcohol resulting in harm to physical and mental health and impairment of social and occupational activities [15]. The studies addressing the association between AUD and suicide among drug abusers or among patients with mental disorders were excluded. We included observational (cohort, case-control, and cross-sectional) studies addressing the association between AUD and suicide. The primary outcomes were suicidal ideation, suicide attempt, and completed suicide.

A Georgia mother is mourning the violent deaths of her three children — aged 9, 11 and 13 — whose bodies were found along with a deceased man in a Gwinnett County, Ga., park around 1 a.m. Emergency admission rates for hip fractures have also decreased over the last decade for those aged 65 and over and in those aged 80 plus. For the 65 to 79 age group, adhd and alcohol the admission rate remained similar to the rate in 2010 to 2011 (Figure 6). This indicator measures self harm events severe enough to warrant hospital admission. These hospital admissions are used as a proxy for the prevalence of severe self harm. There is a significant and persistent risk of future suicide following an episode of self harm.

Using the psychological autopsy method, Heilä et al. [254] investigated schizophrenic subjects in whom active illness and depressive symptoms were highly prevalent immediately before suicide and a history of suicide attempts was common. Women were more likely to have committed suicide during an acute exacerbation of the illness. Alcoholism was most common among middle-aged men (45%), whereas middle-aged women had a high rate of depressive symptoms (88%). They noted that younger male subjects most often used violent suicide methods. A state of intoxication may trigger self-inflicted injuries, not only by increasing impulsivity, but also by promoting depressive thoughts and feelings of hopelessness, while simultaneously removing inhibiting barriers to hurting oneself [177]. Indirect mechanisms, including alcohol consumption as a form of self-medication for depression, or alcohol use as a marker for other high-risk behaviors, may also be relevant.