Does Substance Use Increase the Risk of Suicide?

Drug addict sitting depressed in a building.

Families know. They look at a loved one who’s heavily using drugs or alcohol and they see the destruction. The person consuming the drugs or quarts of vodka may be oblivious to the harm being done but from the outside, the destruction is obvious.

What the family may not realize is that they are also looking at a situation that can easily end in suicide. That possibility exists whether their loved one is using alcohol, opioids, cocaine, synthetics or even marijuana. The Substance Abuse and Mental Health Services Administration summarized some of the most telling statistics related to substance use and suicide.

  • 22% of deaths resulting from suicide involve alcohol intoxication
  • Suicide is a leading cause of death among people who misuse alcohol and drugs
  • Opioids such as heroin or painkillers were present in 20% of suicide deaths
  • Drugs or alcohol increase suicide because of the disinhibition that occurs when a person is intoxicated
  • When a person chronically misuses alcohol, their risk of suicide is ten times greater than the average
  • When a person injects drugs, their risk of suicide is 14 times greater.

Alcohol and Suicide

When a person is intoxicated by alcohol, there is not only a disinhibition that occurs, there’s also a greater and uncontrolled impulsiveness. Anyone around a heavily intoxicated person also knows that their judgment is seriously impaired. But there is one more factor that may link alcohol to suicide or suicide attempts. And that is that alcohol may be used to blot out a person’s distress over wanting to commit suicide.

The connection between heavy alcohol use and suicide has been intensively studied. One of these studies compared those who had been diagnosed with alcoholism with the general population that does not suffer from mental illness. This study found the alcohol misuser’s risk of suicide to be 60 to 120 times higher than the general public’s.

Cannabis and Suicide

There are plenty of people who want the public to believe that marijuana use is harmless. But science hasn’t supported this idea.

In 2017, the National Academies of Sciences, Engineering, and Medicine reported that the use of marijuana is strongly associated with the development of psychosis and schizophrenia. There is also an association between marijuana use and depression, suicide and other disorders. The report notes a higher incidence of thoughts of suicide, attempted suicide and completed suicide among heavier users of this drug.

And are many marijuana consumers heavy users of this drug? While only one in 15 drinkers consumes alcohol daily, among marijuana users, one in five is a daily user.

Opioids and Suicide

Opioid pills on the floor, hand hanging from the bed.

Plenty of people know that America loses tens of thousands of people each year to opioid overdoses. But it’s not well-known that a significant proportion of these people intentionally take their own lives.

It’s impossible to come up with an exact number of these people. But one report estimated that 30% of opioid overdoses may fit in this category. An analysis of National Vital Statistics also showed major increases in suicides involving opioids among all age groups except teens and young adults. The increase was alarmingly steep among those aged 55 to 64 – in this group, the rate of suicide quadrupled between 1999 and 2014.

There’s one more heartbreaking statistic in this area. A 2017 study revealed that a person who was addicted to prescription opioids was twice as likely to attempt suicide as a person who did not misuse those drugs.

Other Drugs

These aren’t the only drugs associated with a higher risk of suicide. Heavy stimulant use is associated with paranoia and delusions. So it’s quite possible for cocaine, methamphetamine and newer stimulants like mephedrone or ethylone to trigger a desire for or accomplishment of suicide.

As an example, there is the case of young Thomas Hughes, a junior banker in New York City, who continued writing business-related emails until a few minutes before he jumped from his 24th-floor apartment. His toxicology report noted that he had cocaine and ethylone, a drug usually categorized with bath salts, in his body at the time of his death.

And there was the case of banker Neil McCormick who returned to London after a stint in Hong Kong. At a barbecue in his honor, he was seen snorting cocaine and later vaulted off the fourth floor of the home to his death. One of his friends described him as having been a “little bit paranoid.”

Rehab Can Be Life-Saving

The fact is that an overdose is not the only way drug and alcohol abuse can cause death. The heavy use of many different kinds of drugs can eliminate a person’s hope for any kind of future at all, much less a bright or hopeful one. The loss of that hope may trigger a desire to end one’s life.

This tragic possibility is yet another compelling reason to pull out all the stops to get a loved one into an effective rehabilitation program at the first moment possible.


Reviewed by Claire Pinelli, ICAADC, CCS, LADC, MCAP, RAS


Karen Hadley

For more than a decade, Karen has been researching and writing about drug trafficking, drug abuse, addiction and recovery. She has also studied and written about policy issues related to drug treatment.