Suicide and Substance Use Disorder

Abstract

Premature mortality trends in the United States are alarming, and years of life lost are mainly attributable to substance-related deaths and suicide. Suicide risk is significantly elevated among those with substance use and substance use disorder, even after adjusting for co-occurring mental health disorders and other social determinants of suicide risk. Potential mechanisms underlying these associations include the acute intoxication effects of substances on disinhibition, impulsivity, aggression, and psychosis; overlapping social and medical risk factors associated with both substance use disorder and suicide risk; and possibly overlapping genetic determinants in stress response circuitry and neurotransmitter functioning. Evidence-based treatments for substance use disorder (both medication interventions and psychosocial treatments) are effective in reducing substance use and suicide risk. Further development of universal suicide risk screening protocols and prevention training and education is especially important for the person at risk for using substances. [ Psychiatr Ann . 2020;50(4):158–162.]