New research has shed light on the complexity of how substance abuse affects a person’s risk of suicide. The study, published in the journal Crisis, examined hundreds of suicidal emergency department (ED) patients from across the country and found that patients who reported using both cocaine and alcohol had a higher risk of suicidal behavior, though the significance of the correlation differed by age, gender and race. These results could help identify specific factors that can be used to better assess and identify people who are at risk for suicide, say the study authors.
The team of researchers examined 874 suicidal men and women who were admitted to emergency departments across the United States between 2010 and 2012. After examining the data collected from the suicidal ED patients, the team found that the combination of alcohol and cocaine use increased the patients’ risk of attempting suicide again in the year following the ED visit. Even though the people in the study reported using other substances, including cannabis, prescription painkillers, tranquilizers and stimulants, only the combination of alcohol and cocaine showed a significant association with a future suicide attempt.
The patients included in the analysis either reported a recent suicide attempt or having suicidal thoughts at the time of the ED visit, as part of a larger study, the Emergency Department Safety Assessment and Follow-up Evaluation led by the University of Massachusetts Medical School.
Of the study population, 298 reported using alcohol and 72 reported using cocaine, while 41 reported using both. For the patients using both alcohol and cocaine, their chance of a repeat suicide attempt was 2.4 times greater than those who didn’t. When the researchers followed up with participants in the year after the ED visit, they found that of the 874 people in the study, 195 had attempted suicide at least once.
But even though suicidal ideation is often linked to drug abuse, the study findings do not confirm a “clear-cut, straightforward association,” said study lead Sarah Arias of the Alpert Medical School of Brown University. She said the purpose of the data is to contribute to our knowledge of how the misuse of certain drugs by certain people could affect a person’s suicide risk. The study found that suicide risk differed by age, gender and race. For example, the association between substance abuse and suicidal behavior was stronger in older people, and substance abuse was not as strong of a predictor of suicide risk among white people and women, suggesting “women may be differentially at risk depending on whether they report substance use or past suicide attempts,” said Arias.