Substance Abuse and Suicide Prevention: Evidence and Implications: A White Paper

http://www.samhsa.gov//matrix2/508SuicidePreventionpaperfinal.pdf
What’s one of the biggest
risk factors for suicide?
According to a new
SAMHSA white paper, the
answer is substance abuse.
“The connection between substance
abuse and suicide has not been
sufficiently well understood,” said
Richard McKeon, Ph.D., M.P.H., Public
Health Adviser for Suicide Prevention
at SAMHSA’s Center for Mental Health
Services. “People in both the mental
health and substance abuse fields
have likely had experiences that would
demonstrate the connection, but I
think that probably few appreciate the
magnitude of the relationship between
substance abuse and suicide.”
Recently released by SAMHSA’s Center
for Substance Abuse Treatment (CSAT),
“Substance Abuse and Suicide Prevention:
Evidence and Implications: A White
Paper” summarizes what’s known about
the interrelationship. “The paper provides
an overview of advances that have been
made in the last decade,” explained Project
Officer Jorielle R. Brown, Ph.D., a public
health adviser in CSAT’s Co-Occurring
and Homeless Activities Branch.
Calling for a public health approach
to suicide prevention, the paper urges
practitioners in both the mental health
and substance abuse fields to use
that knowledge to improve suicide
prevention efforts.
“The paper underscores the need for
people in the mental health field to be
aware of substance abuse issues and cooccurring
disorders as well as for substance
abuse professionals to be aware of the risk
of suicide,” said Dr. McKeon. “There needs
to be increased collaboration.”
A Complex Interrelationship
The white paper’s first section
focuses on the epidemiology of suicide.
In the U.S. alone, suicide kills more
than 32,000 people a year. That’s the

equivalent of a death by suicide every
16 minutes. In addition to the tragedy
of lives lost, suicide costs the Nation
almost $12 billion in lost income.
The paper’s next section offers
an overview of what’s known and
unknown about how substance abuse—
both drugs and alcohol—affects the
risk of suicide. Since the Surgeon
General issued a call to action to prevent
suicide in 1999, the paper notes,
scientific knowledge about suicide
prevention has increased dramatically.
E
According to the white paper, a
growing body of evidence suggests
that alcohol and drug abuse are second
only to depression and other mood
disorders when it comes to risk factors
for suicide. In one study, for example,
alcohol and drug abuse disorders were
associated with a six-fold increase in the
risk of suicide attempts. And substance
abuse and mental disorders often go
hand-in-hand, the paper emphasizes.
The paper ends with a call for a more
integrated, public health approach to
preventing suicide.
Because of cultural taboos, the paper
notes, it has only been in the last decade
or so that the public health field has
focused its attention on suicide. With the
realization that people with mental health
and substance abuse disorders can recover
has come the recognition that people at
risk for suicide can be treated.
What’s needed, the paper argues,
is an approach that targets the entire
population, relies on best practices, and
addresses the full range of risk factors,
adding substance abuse to better-known
risk factors such as mental illness and
certain biological and environmental
characteristics. The approach should
focus on prevention just as much as
diagnosis and treatment.
“There’s a need for a comprehensive
approach if we want to reduce suicide
attempts and death by suicide,”
emphasized Dr. McKeon. “It’s not
sufficient to rely simply on mental health
treatment, since we know that the majority
of those who die by suicide have never had
any mental health treatment. To reduce
suicide, everyone needs to be involved.”
To download a free copy of the
white paper, go to www.samhsa.gov
/matrix2/508SuicidePrevention
PaperFinal.pdf.
—By Rebecca A. Clay