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Addiction and suicide: A review.
Christine Yuodelis-Flores1, Richard K Ries1
1University of Washington, Department of Psychiatry and Behavioral Sciences, Seattle, Washington.
The American Journal on Addictions
|February 4, 2015
Summary
Suicidal behavior is common in patients with substance use disorders and co-occurring mental illnesses. Risk factors like relationship issues, stressors, and prior attempts intensify suicide risk, necessitating integrated treatment approaches.
Area of Science:
- Addiction Medicine
- Psychiatry
- Public Health
Background:
- Suicidal behavior is a significant concern among patients seeking addiction treatment, with up to 40% reporting a history of suicide attempts.
- While risk factors for suicide are known in the general population and those with mental illness, less is understood about individuals with substance use disorders and co-occurring conditions.
Purpose of the Study:
- To examine the risk factors for suicide and suicide attempts in patients with alcohol and drug use disorders, particularly those with co-occurring mental illnesses.
- To inform treatment strategies for addiction specialists managing patients with suicidal behavior.
Main Methods:
- A review of studies, psychological autopsies, and recent literature on suicide risk factors in patients with substance use disorders.
- Analysis of the relationship between substance use disorders, co-occurring mental illnesses, and suicidal behavior.
Main Results:
- Predisposing and precipitating factors, including relationship disruption, occupational/financial stressors, recent substance use, and a history of suicide attempts or sexual abuse, significantly increase suicide risk.
- This risk is further intensified by personality traits and co-occurring mental illnesses.
- Major depression, bipolar disorder, borderline personality disorder, and post-traumatic stress disorder are strongly associated with suicidal behavior in individuals with addictive disorders.
Conclusions:
- Suicidal behavior presents a substantial challenge for individuals with co-occurring disorders undergoing addiction treatment.
- Effective risk assessment and management of suicidality are crucial throughout the treatment process.
- Addiction treatment providers must routinely inquire about clients' suicidal histories, thoughts, and plans to develop comprehensive treatment strategies.