Addiction and Suicide: An Unmet Public Health Crisis

Abstract

Suicide is the tenth leading cause of death in the United States, with 44,193 suicides occurring each year, or 121 completed suicides per day. Approximately 494,169 individuals present to hospitals each year because of self-harm (1). Globally, it is estimated that about one million people die annually from suicide, equivalent to one death every 40 seconds. Suicide is a complex phenomenon caused by neurobiological, sociocultural, and genetic factors. This complexity is linked to risk factors such as chronic substance abuse, concomitant mental illness, personal stressors, family breakdown, previous suicide attempts, access to firearms, and history of lifetime physical or sexual abuse. These risk factors can interrelate with each other, be a product of each other, or operate independently. There is a strong association between suicide and psychiatric disorders, and it has been estimated that up to 90% of people who commit suicide have one or more psychiatric comorbidities. Among these, affective disorders and posttraumatic stress disorder (PTSD) are associated with the strongest risk. Risk increases further among individuals who use alcohol. It is estimated that alcohol dependence alone carries a 7%-lifetime risk of suicide, compared with a 6% risk for affective disorders (2). Vulnerability is significantly increased and risk doubles with concomitant mental illness and substance use disorders, compared with affective disorders or alcohol misuse alone (3). Relative to the general population, individuals with substance use disorders are 10–14 times more likely to commit suicide (4).