How Much Does Substance-Related Depression Increase Risks for Suicide?

People affected by problematic substance use are unusually likely to develop symptoms of major depression or some other form of diagnosable depressive disorder. People with serious substance issues also have clearly heightened chances of attempting suicide. In a study published in July 2014 in the Journal of Studies on Alcohol and Drugs, a team of U.S. researchers assessed the contribution that substance-related depression makes to suicide risks and compared that contribution to the influence of depression not related to substance use. These researchers concluded that both sources of depression increase the short-term odds that a person will make a suicide attempt.

Substance Use and Depression

Substance use is more common among people affected by mental illness than among the rest of the U.S. population, the federal Substance Abuse and Mental Health Services Administration reports. This finding clearly applies to people affected by major depression. Among people who don’t have the symptoms of this disorder, the overall rate for illicit/illegal drug use is roughly 14.8 percent. Among people who do have major depression symptoms, the rate of use nearly doubles to 28.5 percent. The figures are even starker for people affected by substance use disorder (diagnosable substance addiction and non-addicted substance abuse). Adults with a substance use disorder diagnosis have symptoms of major depression almost three times more often than adults without a substance use disorder diagnosis.

Substance Use and Suicide

Overall, people diagnosed with substance use disorder try to kill themselves almost 500 percent more often than people unaffected by diagnosable substance problems. Especially among people with a prior record of military service, the actual rate of suicide-related death is also much higher among those individuals impacted by substance addiction and/or substance abuse. Despite these facts, the bulk of all people diagnosed with substance problems will never try to kill themselves or successfully complete a suicide attempt. The suicide risks for people with diagnosable substance issues largely reflect the risks found in other segments of the population. In addition to having depression symptoms, they include having a prior history of attempting suicide and being older and male. Since substance use disorder and depression occur together with such frequency, the combined risk from these two factors may elevate a person’s chances of making a suicide attempt. Risks may also be higher in people who have simultaneous, diagnosable problems with both alcohol and drugs.

Comparing the Risk Contributions

In the study published in the Journal of Studies on Alcohol and Drugs, researchers from the University of Rochester Medical Center and the State University of New York at Buffalo used an examination of 200 adults to assess the contributions that substance-related depression and non-substance-related depression make to the odds that any given person will make a suicide attempt in the near future. All of these adults were receiving treatment in a residential program for substance use. Half of them had a previous history of making at least one suicide attempt, while the other half did not. The researchers used a detailed analysis of the group as a whole and each individual to separate the risks attributable to substance-related depression from the risks attributable to depression not linked to substance use.

The researchers concluded that 60 percent of the study participants who had previously attempted suicide were affected by substance-related depression. They also concluded that only 35 percent of the participants with no history of suicide attempts had depression symptoms related to their substance use. Thirteen percent of the participants with a history of suicide attempts were affected by depression not related to the use of drugs or alcohol. Among participants with no history of suicide attempts, the rate for non-substance-related depression was just 3 percent.

The study authors found that, overall, the presence of substance-related depression accounted for 44 percent of the suicide risk in the participants who had attempted to kill themselves. They also found that the presence of non-substance-related depression accounted for 12 percent of the risk. Based on the findings, the authors came to several conclusions. First, both substance-related depression and non-substance-related depression significantly increase the odds that problematic substance users in general will make a suicide attempt in the near future. In addition, substance-related depression increases the odds that problematic substance users in general will make a suicide attempt at any point in time. Interestingly and somewhat paradoxically, in any single individual, depression not related to substance use may be a more important factor in suicide than depression related to substance use.

Posted on December 23rd, 2014
Posted in Mental Health

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