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Suicide & Substance Abuse: What Is the Connection?

The connection between substance abuse and suicide is profound. Over 90% of people who die by suicide experience depression, a substance abuse disorder, or suffer from both. Suicide is one of the leading causes of death for Americans.

Suicidal thoughts and substance abuse affect behavior in a circular loop. For many people who experience Major Depression, substance use may appear to lessen their negative symptoms. In fact, substance use increases the length of depressive episodes and leads to a higher rate of suicidal thoughts.

Talking about suicide and addiction can feel like a loaded topic for many people. For people and their loved ones who are battling thoughts of suicide and substance abuse, understanding the connection between the two will ease any unnecessary social stigma. Knowing that you are not alone and help is available is the first step in seeking relief.

The National Suicide Prevention Lifeline is available for free, 24 hours a day at 1-800-273-8255.

Experts have shown a connection between mental health issues and substance abuse. Risk factors, warning signs, and care plans are varied.

What Is Substance Abuse?

Substance abuse is also known as being addicted to drugs or alcohol. It is an addiction and a disease. Substance abuse can happen to anyone but is prevalent in people experiencing mental health challenges. Substance abuse is defined by the National Institute on Drug Abuse (NIDA) as chronic and relapsing behavior that seeks drugs despite negative consequences.

This also includes alcohol. Addiction is a brain disorder because it causes changes to the brain’s reward, stress, and self-control circuits. Despite negative consequences, people suffering from addiction experience a mental obsession that keeps them using.

Reasons People Use Substances


Makes them feel good

Substances can flood the brain with feelings of pleasure. Substances have varying short-term effects on the body and brain. Alcohol temporarily numbs stress and anxious feelings while opioids produce euphoria (feeling high).

 Makes them feel less stressed

Many substances temporarily lessen the feelings of anxiety or stress because of their effect on the brain. The issues causing stress don't go away though, so coming down from substances usually makes the stressful feelings worse.

 They were prescribed

Sometimes a prescription to painkillers can lead to addictive behavior. Benzos, drugs prescribed for anxiety and panic attacks, are also often abused.

 Social pressure

Most often teens and younger people are susceptible to peer pressures to try drugs and alcohol. Because the brain is still in development, substances may cause long-term mental health issues and addiction.


Risk Factors for Addiction


There is not one single factor that leads to substance abuse. There are risk factors that may contribute to the likelihood of developing an addiction. The more risk factors an individual has, the more likely they may develop a substance abuse disorder.

Some of these risk factors for youth and adults are:

  • Genetic disposition: research is clear that our genes predispose individuals to potential addiction and mental illness. Predisposition is linked to other risk factors and doesn’t guarantee substance abuse.
  • Poverty: the feelings associated with poverty may cause stress and hopelessness. Poverty decreases community support, healthcare access, and self-esteem.
  • Childhood aggression: Studies show that youth who have a history of aggression such as assault are more likely to start using substances early.
  • Low parental supervision: Uninvolved parenting affects the choice of friends a youth may choose. Youth with little parental relationship are at a greater risk for addiction. Parents or siblings that use also influence the risk factors for addiction.
  • Early drug use: Many people suffering from substance abuse disorder report their addiction began in their youth.
  • Experience of trauma: The more trauma a person has experienced in their lifetime, the greater the risk for addiction. Childhood stress, abuse, the experience of war, and family isolation all contribute to these risk factors.
  • Social isolation: Research shows that people who experience social isolation have different risk and reward sensitivities. This makes the ‘reward’ feeling that substances provide initially more addicting.

Mental Health, Suicide, and Addiction

There is an undeniable link between suicide and psychiatric disorders. Roughly half the people who experience mental illness in their lifetime will also suffer from a substance use disorder. Certain mental health disorders have a greater risk for addiction than others.

But, addiction can’t always be described as a result of mental illness. Sometimes substance abuse leads to or contributes to the development of the mental disorder. Drug use that occurs before the symptoms of mental illness may have produced the brain changes that allowed for a genetic predisposition to take hold.

Addiction to drugs and alcohol will make the symptoms of depression and mood disorders worse. This increases the risk of suicidal ideation.

Researches have found that physical health and mental health are linked. People experiencing chronic pain also have a greater likelihood to have a mood disorder. Living with chronic pain can lead to negative emotional pain, which many people self-medicate with substances.

Early treatment of both mental health issues and substance abuse will greatly lessen the risk and causes of suicidal thoughts. When mental health issues are left untreated, addiction often gets worse. Substance abuse treatment is a well-researched and proven method to provide needed help.

Depression and Suicide

Most people who experience mild or major depression do not die by suicide. Yet, it does increase the risk. The risk increases by the severity of the depression.

Men suffering from depression have a five times higher risk than women. The U.S. Department of Health suggests 60% of people who die by suicide have a mood disorder. Younger people who commit suicide are often addicted to drugs or alcohol.

Link Between Suicide and Substance Abuse

Suicide is a deliberate action to end one’s life. The risk of suicide is greatly increased when someone is experiencing depression and substance abuse issues. Over 41,000 Americans die by suicide every year and one in twelve adults in the U.S. have a substance abuse disorder.

The numbers are staggering. Opioids are present in 20% of suicide deaths and alcohol intoxication is involved in 22%. Alcohol is also present in 30-40% of all suicide attempts.

The occurs because intoxication creates feelings of lower inhibition. Lower inhibition may allow someone to act out or behave in ways they would never do otherwise. The Substance Abuse and Mental Health Services Administration (SAMHSA) states alcohol:

  • increases mental distress
  • increases aggressive behavior and thoughts
  • puts suicidal thoughts into action
  • impairs cognition (awareness) and coping strategies

The rate of major depression, including bi-polar disorder, is two to four times higher for people suffering from addiction than the general population.


Suicide and Addiction Risk Factors

Risk increases for people diagnosed with mental health disorders. These include depression, Anxiety Disorder, Bipolar Disorder, Post-Traumatic Stress Disorder, and personality disorders. Suicide risk is highest for those diagnosed with Bipolar Disorder.

Because substances affect the brain in both the short-term and long-term, drug and alcohol abuse can cause personal relationship problems. This may cause social isolation or co-dependency issues for the person experiencing addiction.

Because addiction creates changes to the brain chemistry, it disrupts the body’s reward system. Without their substance of choice, people experiencing addiction may not feel joy or happiness. Drug and alcohol abuse also lead to feelings of apathy and ‘giving up.’

Different substances also enhance different behaviors in the user. Alcohol lowers inhibitions and may allow an intoxicated person to act on suicidal impulses they otherwise would not follow through on. Opioid users may take a lethal dose due to impaired judgment.

There are known risk factors that researchers have complied. The Psychiatric Times provide these risk factors for suicide:

  • Older men with an addiction disorder are at greater risk than younger people
  • For veterans, men with addiction disorder are 2.3 times and women 6.5 times more likely to die by suicide than veterans without addiction
  • Past attempts are a strong factor for future suicidal thoughts
  • Violent or prior aggressive behavior shows a link to suicide attempts
  • Family history of suicide or violence
  • Having access to firearms in the house

Warning Signs of Suicide

Although there is a profound link between suicide and addiction, there is not one singular cause. There are warning signs to look out for. People experiencing suicidal ideation may not always seem to be in outward mental distress.

They may behave in ways that show:

  • talk about wanting to die
  • talk about unbearable pain
  • talk about being a burden
  • extreme mood swings
  • withdrawing from social groups
  • increasing substance use
If you notice these warning signs, the National Lifeline Hotline is available 24/7 at 1-800-273-8255.

Opioid Use and Suicide

Opioid prescriptions almost doubled from 116 million in 1999 to a peak of 255 million in 2012. The rate has dropped since then, but in 2020, over 142 million opioids were still prescribed. And, the rise in suicides related to opioid use has also dramatically risen over the last two decades. 

Opioids work by attaching to receptors on the brain’s nerve cells. They block pain messages from the body. Opioids also release dopamine, the ‘feel good’ chemical.

Opioids include:

  • Heroin or Methadone
  • Morphine
  • Codeine
  • Vicodin (Hydrocodone)
  • OxyContin or Percocet (Oxycodone)
  • Fentanyl

Warning Signs of Opioid Addiction

There are signs that using opioids is creating an addiction. While opioids have an important role in the medical field, they are easily abused. This is because of their ability to flood the brain with feel-good chemicals.

  • Urges to use the drug daily or multiple times a day
  • Taking more than you are prescribed or more than you intend to
  • Always keeping some on you
  • Buying drugs when you can’t afford them
  • Isolating yourself from others
  • Stealing or lying to get high
  • Participating in dangerous activities

Researchers found that heroin use increases suicidal risks by over 13 times compared to the general population. People diagnosed with chronic pain have a greater risk for opioid abuse, mental illness, and suicidal thoughts. Prescription painkillers are found in over 97% of all opioid-related suicides.

Some studies show evidence that people with opioid addictions involving prescription drugs are twice as likely to make a suicide attempt. This number is compared to people who use opioids as prescribed.

There is a direct link between chronic pain and depression. Studies also show that a significant amount of non-fatal overdoses are potential suicide attempts. Many people suffering from acute depression and drug dependency lose the will to go on.


Opioid Withdrawal Symptoms

Treatment for opioid abuse is necessary for healing mental health symptoms and preventing suicide. Detoxing from opioids is best undertaken with the guidance of professional help. It is uncomfortable and people generally experience flu-like symptoms which can include:

  • vomiting
  • anxiety
  • restlessness
  • muscle aches
  • rapid heartbeat
  • blurry vision
  • diarrhea

Withdrawal usually occurs within the first twelve hours since taking an opioid drug but improves within 72 hours.

Alcohol Use and Suicide

Alcohol use and mental health issues are linked and well-known in society. Many people use alcohol to relieve their stress, celebrate, and generally feel better. The downside to this is alcohol works as a depressant on the body.

A depressant changes the neurotransmitters in the brain. This affects emotions, thoughts, and behavior. It is widely known that drinking lowers inhibitions, making it seem easier to act out in ways that are not usual.

The long-term effect of alcohol abuse is a reduction in neurotransmitters. These chemical messengers are needed to combat negative mental states like depression and anxiety. This becomes a deadly cycle because feelings of depression can encourage the desire to drink to numb negative stress.

People who abuse alcohol are five times likely to die by suicide than the general public. These numbers are alarming. 40% of people who undertake an alcohol treatment plan admit to at least one suicide attempt in their lifetime.


Warning Signs of Alcohol Abuse

Using alcohol is socially acceptable in America. It does not hold the same social stigmas of other substances but it still has the same dangers. Here are some common warning signs to watch for.

  • You drink more than you intend to
  • Can’t cut back despite trying
  • Crave alcohol or plan your day around it
  • Continue drinking even when it causes problems
  • Injure yourself or others while intoxicated
  • Experiencing relationship, work, or school problems because of it

Warning Signs of Alcohol Abuse

The symptoms of alcohol withdrawal are different for everyone. They depend on the length of abuse and the amount regularly consumed. Symptoms ranged from mild to severe and should be supervised by a professional.

Because alcohol depresses the nervous system, it forces the body to work harder. The symptoms may begin only six hours after the last drink. Symptoms range from:

  • Anxiety
  • Body shakes
  • Headache
  • Vomiting
  • Insomnia
  • Cold sweats
  • Seizures
  • Confusion
  • Fever

Benzo Use and Suicide

Benzodiazepines are often prescribed to treat anxiety disorders. They are also prescribed for insomnia issues. They are highly addictive with withdrawal symptoms occurring after only four weeks of use.

Benzo use is associated with higher suicide risk. These drugs create depressive symptoms or make previously existing symptoms worse. The most commonly prescribed benzodiazepines are Xanax, Valium, and Ativan.

Long-term use of benzos means taking them consistently for more than two to four weeks. Long-term use can result in greater anxiety, reduced capacity for learning, and an increase in suicide risk. Withdrawal symptoms begin to occur in between prescribed doses.

Mixing alcohol and benzodiazepines is incredibly dangerous. Both work to depress the central nervous system.

Benzo use causes many side effects including mood disorders and other health issues. These side effects are often misdiagnosed and not linked to benzo drug use. Because the side effects of benzo abuse include mental health disorders, their impact negatively affects every aspect of the user’s life.


Warning Signs of Benzo Abuse

This class of drug is known as a tranquilizer. They are one of the most common prescriptions in America. The availability and highly addictive nature of these drugs make them one of the most abused substances. Some signs to look out for benzo abuse include:

  • loss of appetite
  • changes in appearance
  • abrupt mood changes
  • lack of work or school progress
  • taking more than prescribed
  • seeking drugs after prescription expires

Benzo Withdrawal Symptoms

Benzo substance abuse treatment is complicated and it is recommended for professions to oversee. These drugs are dangerous to detox from because an abrupt stop in use may cause seizures or other serious medical issues. Benzo use must taper down before stopping.

Withdrawal symptoms may begin to show between regular use. It may take up to a month for the drug to leave the body and symptoms can last for a long time. Some of these include:

  • slurred speech
  • body shakes
  • bloody nose
  • irritability

Protective Factors to Prevent Suicide

We know that the presence of a mental illness is a risk factor for both suicide and substance abuse. If you, or someone you love, are experiencing addiction, there are protective measures that help prevent the risk factors for suicide. Death by suicide is caused by multiple factors and is never someone’s ‘fault.’

By strengthening protective factors, it increases the resilience and self-confidence of a person experiencing depression and addiction. Resilience will lessen suicidal thoughts and actions. Here are some ways to build resilience:

  • Connections: Building connections with friends and family to have someone to turn to when depressive or mood disorder feelings arise.
  • Caring for others: Having pets, children, or older parents in the home creates a protective factor and gives reason to live.
  • Self-Esteem: Maintaining interests and hobbies build self-esteem and encourage optimism and value of life.
  • Restricted weapons: For people experiencing addiction and mental health disorders, keeping access to lethal means of suicide away from them may save their life.
  • Access to health care: Build a relationship with a primary care doctor, clinic, or mental health resource center.

Encouraging the reasons to live is a major part of recovery for both suicidal thoughts and addiction. Using substances create artificial feelings of joy and euphoria. When these effects wear off, the person is often left with feelings of despair, loneliness, and thoughts around the social stigma of using.

These negative feelings may lead to suicidal thoughts. This is why it is essential for people experiencing substance abuse to seek connections with others and help for their condition.


What You Can Do to Help with Suicidal Warning Signs

If someone you know is experiencing substance abuse disorder and showing signs of suicide, it is important to show them you care. Ask them directly if they are experiencing suicidal thoughts. If you don’t feel comfortable asking, reach out to a professional or family member who does.

According to the Suicide Prevention Lifeline:

  • Do: be direct when asking about suicidal thoughts
  • Do: be willing to listen to and accept feelings
  • Do: show interest and support
  • Do: remove weapons and pills
  • Do: offer hope, get help from professionals  
  • Don’t: act surprised, it will create distance
  • Don’t keep secrets, instead seek outside support
  • Don’t: be judgmental or lecture 

Providing Help Through Treatment


The link between suicide and addiction is clear. It is important for people experiencing thoughts of suicide and substance abuse issues to seek help. If you know someone who is showing warning signs, reach out and let them know they are not alone.

Suicidal thoughts are a symptom of treatable conditions. Detoxing and stopping the use of drugs and alcohol is challenging, but not impossible. Residential treatment offers the highest level of support to end substance abuse and manage mental health.

For more information on 24-hour, residential treatment and help, contact Restore Detox Centers today.


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