Suicide is one of the leading causes of death in the United States (10th, according to a CDC report from 2018). These deaths and suicide attempts are often attributed to mental illness and disorders such as major depression, anxiety disorder, bipolar disorder, post-traumatic stress disorder, and others. It is also assumed that a person has to be going through a particularly difficult period in order to even consider ending their life.

However, there are many risk factors and warning signs of suicide. While mental health issues are certainly a big factor, so is substance abuse, past history of suicide attempts, and many more. It is not always easy to notice when someone is having suicidal thoughts and behavior, especially if you don’t know what some of the less obvious warning signs are.

In this post, we will break down everything you need to know on substance abuse and suicide. We will discuss what type of substance abuse disorders could lead to suicidal ideation, what the most common risk factors are, and how you can recognize all the warning signs so that you might help someone you care about.

Substance Abuse and Suicide

In the science community, there is no doubt that substance abuse disorders of any kind lead to an increased risk of death by suicide. One study even mentions that substance abusers are six times more likely to try to end their life than non-abusers. These numbers are staggering and worrying at the same time.

Does it matter what type of substance an individual is addicted to? Well, yes and no. It seems that some substances may increase the risks of suicidal behavior more than others. Let’s take a look at some of the most common substances and how they might contribute to a suicide attempt.


Alcohol poses a threat to everyone, not only alcohol abusers. Even those who enjoy alcohol only occasionally and do not suffer from alcohol use disorders may find themselves with suicidal thoughts – given there are other risk factors present. There are different ways that alcohol abuse increases the risk of suicide.

  • Increasing reckless and impulsive behavior
  • Lowering inhibitions
  • Causing distressing events, such as big arguments, relationship breakups, violence, and aggression
  • Depressing the nervous system, possibly leading to more intense states of depression, if a person is already suffering from it

If someone is already diagnosed with a mental health disorder – and especially if they are receiving treatment for it – they should avoid alcohol as much as they can. If any other risk factors for suicide are present, it is not a good idea to consume alcohol in any capacity.


Those suffering from opioid use disorders are addicted to medication such as morphine and methadone, but also to illegal drugs such as heroin. Even individuals who are taking prescription opioids (for treating long-term pain) are at greater risk for suicide than those who aren’t.

Unlike alcohol, the way opioids may lead to attempted suicide is not so direct. They typically do not cause reckless behavior or lower inhibitions. Instead, persons addicted to opioids often suffer from a co-occurring disorder, such as a mental health issue or a physical health condition that prevents them from leading a healthy life. Chronic pain and terminal cancer patients – those who most commonly take prescription opioids – have a lower quality of life from the start, which is a major contributor to intensified suicidal ideation.


Stimulants are drugs like cocaine and amphetamines. They stimulate the nervous system, meaning they can cause a state of mania and euphoria, temporarily increase energy levels, and even speed up thought processes.

However, with this ‘high’ and general body and mind stimulation also comes an increase in impulsive drives. While under the effect of the stimulant, a person may not care what happens to them or may not even understand the full consequences of their actions in the moment. Such recklessness easily leads to accidents and unintentional suicides, even twice as much as in the case of opioid abuse.


In stark contrast to stimulants, sedatives are drugs that slow an individual’s thought processes, calm them down, lower their heart rate, and even induce sleep. The group of medications commonly prescribed as sedatives is benzodiazepines. Barbiturates are not so common in modern medicine anymore (because of their addictive nature), but they can be a substance of choice for an addicted person.

Scientific research has yet to discover the exact reason why those who abuse sedatives are four times more likely to take their own life. It may have something to do with the fact that people taking sedatives often combine them with alcohol, which is a deadly mix in and of itself, but especially so if it produces a suicidal crisis.

Moreover, sedatives of this kind represent a readily available method of committing suicide. Swallowing pills is a common way of attempting suicide, and prescription sedatives are usually the medication of choice.


In the light of all the legalization movements spreading across the globe, marijuana is considered a safe drug by many. However, scientists advise caution when consuming marijuana products because some risk of suicide is still present.

A study has found the main reason marijuana abusers may lean towards suicide is that they usually harbor feelings of alienation and loneliness, as though they are a burden to their loved ones. The problem with this particular study is that it is unclear whether marijuana is causing this type of depression, or if marijuana serves as a distraction from this type of depression.

In addition to that, marijuana abusers tend to come from lower socioeconomic standing and poor upbringing, which are also risk factors for suicide.

Multiple Risk Factors for Suicide

When considering the connection between substance abuse and suicide, remember that this is a complex link. Someone who smokes marijuana regularly does not necessarily want to end their life. If a person is suffering from alcoholism, it is not a guarantee that they want to commit suicide.

Behind every attempted or completed suicide is a wide range of risk factors. It is never just one thing that pushes a person to this extreme self-destructive act – it is a combination of factors that have likely been going on for a long time. Here are some of the most common risk factors for suicide:

  • Previous suicide attempts
  • Mental health disorders – mood disorders, depression disorders, and other
  • Substance abuse disorders (alcohol and drug)
  • Serious illnesses – chronic pain, terminal diseases, degenerative disorders, ailments that dramatically lower the quality of life
  • Stressful life events – divorce or the end of a romantic relationship, losing a job or financial instability, getting evicted, long-term bullying (online bullying as well), or any other difficult time in someone’s life
  • Losing a loved one, especially if they committed suicide
  • A history of physical, emotional, or sexual abuse and childhood trauma
  • A family history of suicide
  • Impulsive or aggressive behavior
  • Traumatic brain injuries
  • Certain professions, such as members of law enforcement and healthcare workers

Suicide can affect people of all ages, socioeconomic standings, and backgrounds. Keep in mind that suicidal people don’t necessarily have to appear sad or distressed. Even seemingly happy, carefree individuals can inwardly be having suicidal thoughts.

If someone you know has more than one of these risk factors (for example, if they are a healthcare worker who is going through a divorce and also maybe suffering from anxiety), it doesn’t mean they are at suicidal risk. It only means that you should be more aware of your loved one going through a tough time, and maybe even look for warning signs of suicide.

These warning signs can be obvious, but they can also be subtle in certain individuals.

Obvious Suicide Warning Signs

These warning signs are easy to spot because they represent a person more or less directly stating they are thinking of taking their own life. The signs can include:

  • Talking about someone’s desire to die or about death in general; talking about considering suicide
  • Expressing feelings of hopelessness, desolation, having no purpose in life, or no reason to live
  • Talking about feeling lonely, uncared for, how they are just a burden to others, and how other people would be better off without them
  • Actively researching ways to die
  • Writing a will, withdrawing from social activities, giving away personal possessions
  • Saying goodbye to the people close to them

Hidden Suicide Warning Signs

However, not everyone will be so open about their suicidal thoughts. Those who are seriously considering suicide might even attempt to hide it, either to not alarm their friends and family, or to not risk being dissuaded from the act. Some people are extremely good at keeping these grim parts of themselves hidden.

Fortunately, even in these cases, there are warning signs you could look for.

  • Increased substance abuse. A drastic increase in substance abuse – regardless of what the substance is – could indicate that the person has decided to end their life. They may feel like they deserve one ‘last hurrah,’ or that they have nothing more to lose and can descend into their addiction without guilt because it will all be over anyway.
  • Uncharacteristic behavior. Dramatic changes in behavior might point to emotional pain and distress. If someone close to you who is usually reserved or shy is suddenly loud and outgoing – it may be a cause for concern. In the same vein, if a person is suddenly quiet and contemplative, when they were previously the life of the party, something might be troubling them. This may not be a direct indication of suicidal thoughts, but it wouldn’t hurt to check in with your loved one and see how they’re doing.An increase in reckless behavior, such as fast driving or intense sexual activity, is also a covert warning sign for suicide.
  • Problems with sleeping. Changes in sleeping patterns, such as a person staying in bed longer than necessary or being unable to sleep at night, are signs of emotional distress and potentially even a suicidal crisis.
  • Access to lethal means. This is the risk factor for suicide we mentioned when talking about sedatives. If a person with suicidal ideation has easy access to lethal means, they are more likely to attempt suicide. These lethal means can be obvious weapons, such as a knife or a gun, but they can also be pills or something more easy to hide, like razors. If you fear that someone may try to commit suicide, keeping an eye out for lethal means should be a priority.

How You Can Help

If you recognize the risk factors and warning signs and are wondering whether someone close to you intends to commit suicide, there are ways you can help.

  • Immediate Risk

If your friend or family member is actively threatening suicide – such as holding a weapon in their hands – the most important thing is to not leave them alone and talk to them. Even though this is likely a high stress situation, you should try to remain as calm as possible. Ask your loved one to hand over the weapon or lethal means. Do your best to de-escalate the situation and talk them down from the state where emotions are running high.

One of the options is to call 911 and take your loved one to an emergency department. If they are going to therapy, you could also call their doctor or therapist. There is also the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). It would be best to know as many suicide prevention lifelines as you can in case you need to act immediately.

  • Not Immediate Risk

When you start thinking that someone you love is considering suicide, don’t hesitate to ask them about it. Invite them to a private place and gently ask them whether your suspicions are true. Your loved one may not be inclined to confirm this right away, so make sure they understand that you’re asking because you care and because you want to help them. Be compassionate; emphasize that there is nothing they can’t solve, especially if you work together on the issue. Even diseases and mental problems can be managed with the right health treatments.

Usually, suicidal persons just need to know that they are not alone. They need to learn that people care about them and want to see them succeed. Show that you are a reliable, supportive friend or relative, and that you will help them overcome whatever it is that is troubling them.

  • Addiction Treatment

Lastly, if the individual is suffering from substance abuse, getting them into a substance abuse treatment facility will be a step in the right direction. These treatment programs address the physical aspects of addiction, such as overseeing medical detoxes, but they also address the mental and emotional causes for addiction.

Treatment centers assess each person coming in and design a treatment path for that person in particular, making sure that all of their needs are met. During addiction treatment, a recovering addict may be subjected to CBT (Cognitive Behavioral Therapy), individual or group therapy, family therapy, holistic therapy options, and more. All of these help them replace unhealthy thinking patterns that lead to addiction with problem-solving skills and the emotional tools needed to overcome their issues.

By treating substance abuse, mental health professionals also help the recovering addict understand the connection between substance abuse and suicide and how they can prevent suicidal thoughts in the future.

Protective Factors

On the other side of the spectrum, opposite the risk factors, there are protective factors or circumstances and actions that lead to reduced risk of suicide.

  • Easy access to clinical care for any diagnosed (or undiagnosed) physical, mental, or substance abuse disorder
  • Restricted access to lethal means
  • Healthy support system; loving, healthy relationships and an environment in which a person can thrive
  • Open and honest communication; cultivating skills that lead to resolving conflict in non-violent ways; learning how to express emotions when they threaten to take over

While this list of protective factors is not exhaustive, paying attention to these several points will go a long way in preventing suicide. Managing mental disorders, if there are any, and establishing a strong support system and a nurturing, friendly environment are cornerstones of a balanced life.


Science has demonstrated a clear link between addiction and suicide. Substance abuse increases the risk of suicidal thoughts and behavior several times, depending on the substance used. The ones most at risk are alcohol, stimulant, and sedative addicts.

Aside from being aware that substance abuse is one of the risk factors of suicide, you should also know the other factors, such as the presence of a mental disorder, history of trauma, past suicide attempts, stressful life events, and similar. In addition to that, knowing the overt and less overt warning signs of suicide is crucial to understanding when and how to help someone you love who might be struggling.

Suicide is preventable. It just takes a bit of attention and compassion extended to your loved ones, as well as reassurance that you will help them no matter what the reason for wanting to take their life is.

We hope that you found our guide to substance abuse and suicide useful and informative. Right Way Recovery Services are at your disposal if you have any questions or would like expert advice on how to handle a loved one who is not doing too well. Give us a call at (619) 630 – 7844 or visit our website, and we will be more than happy to help you with anything you need. Don’t hesitate!