Suicidal behavior usually occurs early in the course of mood disorders, but only in the final phase of alcohol abuse when social marginalization and poverty, the somatic complications of alcoholism and the breakdown of important social bonds have taken over. Intervention should help people find a motivation to stop drinking, identify the circumstances that motivate them to drink, identify the factors that engender this conduct, and evaluate the possible risk of suicide. Psychotherapy can help individuals learn new methods of coping with stressors and develop social relationship in the community.

Pharmacological Interventions

In contrast to depressive disorders, suicidal acts often only occur at a late stage over the course of the addiction 9 (pp. 44–45). There is accumulating evidence from clinical and epidemiological studies on the link between drug use and suicide among adolescents. Additional research is needed before there is a claim that drug use in adolescence is a cause of suicide ideation or attempts. Another interesting research area would be to systematically examine whether large-scale prevention efforts aimed at drug use reduce the risk of suicidal thoughts and behaviors.

This creates a heightened risk, making it harder to manage distressing emotions or resist dangerous impulses. Understanding this connection is important for recognizing distress and responding effectively. Psychotherapy in combination with psychopharmacological treatment may also benefit from the advantages of each of these modalities 137.

Alcohol use disorder before suicide changes the affective responses in the spouses and the children who are left behind. Survivor reactions to suicide are strongly influenced by the nature of the relationship between survivors and the suicide. Bereavement counsellors should be alert for complex grief and mourning responses among this group of suicide survivors. The estimated global burden of suicide is a million deaths every year 1, and a policy statement produced by WHO in response to this 2 has urged countries to implement suicide prevention policies. The estimated annual mortality from suicide is 14.5 suicides per 100,000 people, about one death every 40 seconds 1. Self-inflicted deaths were the tenth leading cause of death worldwide and accounted for 1.5% of all deaths 3.

• The strength of the study includes the large target number of participants (N~700) and the high number of items assessed.
• Antisocial traits and substance abuse (including alcohol abuse) are strongly connected to suicide.
• It is estimated that about one million people die annually from suicide, i.e., a global mortality rate of 16 per 100,000, or one death every 40 seconds 2.
• Globally, alcohol consumption has increased in recent decades, with all or most of that increase occurring in developing countries.

Signs of Suicide Risk

• There is increasing evidence that, aside from the volume of alcohol consumed, the pattern of the drinking is relevant for health outcomes.
• However, in a later study conducted in Canterbury, New Zealand, Conner et al. 63 failed to detect an effect of gender in mediating the association between alcohol dependence and serious suicide attempts.
• The primary outcomes were suicidal ideation, suicide attempt, and completed suicide.
• After the data collection, a debriefing is conducted with the participants to identify any signs of an impending or acute crisis and to be able to intervene.

Depression, substance abuse, and aggressive behavior disorders have shown to be among the most influential risk factors for suicide in community and clinical studies of adolescents and adults. This paper reviews existing the link between alcohol and suicide epidemiological evidence on the link between the use of more commonly used drugs among adolescents (e.g., tobacco, alcohol, marijuana and inhalants) and suicidal thoughts and behaviors. Alcohol misuse is robustly linked to heightened risk for suicidal ideation, attempts, and deaths in youths and adults 10, 15–17, a phenomenon not accounted for by comorbid psychiatric disorders 18. Cross-national studies indicate a linear relationship between suicide rates and per-capita alcohol consumption 19, 20, suggesting that alcohol may be a key factor in suicide. Indeed, rates of alcohol misuse have escalated over the last two decades 21, 22 in parallel with rising suicide rates 23, 24. Since 2001, past-year prevalence of high-risk drinking has increased by 29.9%, and alcohol use disorder (AUD) by an alarming 49.4% 21.

The final CBT sessions involved an imaginary exposure exercise during which Frank was asked to recall his most recent suicide attempt and then envision himself seeking help before making the attempt. Frank is 45 years old, unemployed, and undergoing court-ordered residential treatment for cocaine dependence following his arrest for drug possession. He reports that he began drinking heavily and using cocaine and marijuana on a regular basis during his late teens. He also reports experiencing frequent “up and down” moods that coincide with his drug use. He has been in numerous romantic relationships, many of which involved physical and verbal altercations.

How alcohol misuse relates to death by suicide.

The guidelines also recommend incorporating promising, but underused, strategies into current programs where possible, expanding suicide prevention efforts for adolescents and young adults, introducing screening programs, and evaluating the prevention programs. Reducing alcohol consumption, thereby rendering the person less abusing and less dependent, may focus on socially reinforcing the sober condition rather than blaming alcohol intake. Increasing the person’s social acceptance is one of the means to reduce suicide thinking. In fact, people with alcohol abuse often are afflicted with self-blame and may feel rewarded or vindicated when the self-fulfilling prophecy of being rejected is realized.

Results

They concluded that the offspring of persons with alcohol dependence are particularly likely to report being detached, switching-off, avoiding the drinking parent and blaming themselves. Offspring described a variety of ways of escaping childhood adversity, such as leaving home significantly earlier than others. Once a decision has been made to attempt suicide, alcohol use may serve several functions. Alcohol may also serve as a “means to an end” as the suicide method itself 182–184. Removing access to any potential means of self-harm, such as firearms, medications, or sharp objects, is a safety measure. This action can create a barrier during a crisis, as many suicide attempts occur during short-term, impulsive moments.

3. Suicidal Behavior and Alcohol Abuse in Affective Bonds and Social Relationships

Males were 2.7 times more likely to have an alcohol use disorder than were females. Those who shot themselves were 2.4 times more likely to have an alcohol use disorder than those who hanged themselves or used other methods. However, although alcohol or illicit drug use is frequently cited as a risk factor for suicide, the authors reported a low prevalence of intoxication, again suggesting that suicide is not simply (or not often) the result of an impulse. Therefore, the use of suicide as a way of solving a chronic problem rather than an impulsive response to stress means that prevention programs based on impulse control, such as crisis intervention, will be less effective in this population.

Particularly for adolescents, family therapy may play a crucial role both in the resolution of the problems and in the recovery of the patient. Translated, this mean that one out of four youths regularly engages in binges and that about the same proportion has started taking alcohol early in their life when their brain is still maturating. Among people with depression, those who consumed substances or alcohol have a higher probability of attempting suicide as compared with depressed individuals who did not 201. In a study of 450 alcohol-dependent men conducted in the mid-eighties, suicide attempts predicted increased alcohol-related problems at one-year follow-up 69, but this has not been confirmed in later studies 70–72.

The focus is on low- and middle-income countries, as the risk of suicide is generally higher due to special socio-economic conditions and self-harm behavior is more common, especially among women 3. This study highlights the problem of alcohol as a contributing factor to the risk of suicide. However, it does not go into the mechanisms of action and statistical evaluations.