The Connection Between Alcohol and Suicide Risk

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Alcohol misuse can cause or exacerbate mental health disorders and behaviors, such as depression, impulsivity, lowered inhibitions, psychological distress, and aggressiveness. Acute use of alcohol (AUA) is how researchers describe the connection between alcohol and suicide. It refers to consuming alcohol within three to six hours before someone fatally or non-fatally makes an attempt on their own life, or whether there is any discernible blood alcohol concentration (BAC) within that person.¹

In this article:

Prevalence of Alcohol and Suicidality

Statistics show alcohol use disorder (AUD) is the second-most common identified mental health disorder among worldwide persons who take their own lives. Even more pertinent, statistical analyses have found that persons who misuse alcohol are three times likelier to exhibit suicidal behaviors than those without AUD.¹

At least 41,000 annual deaths in the United States result from a person taking their own life. The Substance Abuse and Mental Health Services Administration (SAMSHA) reports acute alcohol presence in 30% to 40% of Americans who attempt to take their own lives and 22% of those who committed suicide had a BAC equal to or exceeding the legal limit.²

Compared to people who do not misuse alcohol, those who do have a 10 times higher chance of dying by alcohol and suicide. Hundreds of thousands of emergency room department visits result in medical treatment for patients with alcohol and suicide risk factors. Many of these patients had mixed alcohol and other prescription or over-the-counter drugs when attempting to take their own life.²

Shared Alcohol and Suicide Risk Factors

Alcohol is one of the top factors influencing suicidality, and it is second to mood disorders. However, many other factors may lead to suicidality, including:^{2, 3}

Behaviors that reflect sensation-seeking or risk-taking
Dysfunction within their family
Victimization due to a crime or bullying
Illness, either physical or psychological
History of trauma, abuse, or violence
Relationship problems
Financial hardships
Job dissatisfaction or loss
Social problems such as rejection, isolation, or pressure
History of suicidality

Alcohol and Suicide in Population Subgroups

Researchers studying alcohol and suicide risk factors try to determine if one group is more susceptible than others. Population subgroups help narrow study findings to learn about gender, age, ethnicity, military status, career, education, and much more relating to alcohol and suicide ideations, attempts, and fatalities.

Alcohol and Suicide Risk Factors Among Age Groups

The National Survey on Drug Use and Health shows additional findings of population subgroups on suicidality by age. Out of the 9.4 million people reporting they thought seriously about taking their own lives in the previous year, the following data was also found:⁴

6 million young adults aged 18 to 25 were the highest subgroup to have suicidality, with 806,000 making serious plans and 433,000 attempting to end their own lives
4 million people aged 26 to 49 had serious thoughts of suicide, with 1.1 million making serious plans and 491,000 following through with a suicide attempt
9 million adults over the age of 50 thought seriously about suicide, 754,000 made serious plans, and 196,000 attempted to end their own lives

Past month alcohol use among the 9.4 million respondents connects to suicidality in the following ways:⁴

9% of all adults had thoughts of taking their own lives
1% of all adults made plans to take their own lives
5% of all adults attempted to take their own lives

Alcohol and Suicide Risks Based on Demographics

According to the National Violent Death Reporting System, all races are affected by suicidality, some more than others. Alcohol plays a role in many of the deaths studied, including:⁵

47% of American Indians and Native Alaskans
38% of Hispanic individuals
33% of White people
26% of Black people
23% of Asian and Pacific Islander individuals

Socioeconomic factors correlate with suicidality among the same ethnic groups who passed away by suicide. The following subgroups have higher rates of ending their lives:⁵

Men in all racial demographics
Those younger than 30
Single, or not married, people
High school education or lower
Non-veterans
Those living in urban areas

Binge Drinking and Suicidality

Binge drinking is most prevalent in young adult groups, including college students. Quite a few studies exist on binge drinking and its relation to suicidality. Study results show binge drinking puts individuals at higher risk for considering, planning, and attempting to end their life.⁶

Those who misuse alcohol through binge drinking, heavy drinking, or alcohol use disorder are likelier to consider taking their own lives, even if they had low levels or no depression. However, alcohol misuse does contribute to depressive symptoms leading to suicidality. Theories suggest:⁷

Alcohol misuse leads to alcohol-related problems
Alcohol misuse leads to adverse life experiences
Problems and negative life experiences lead to depressive symptoms
Depressive symptoms lead to suicidality

Correlation Between Alcohol Use Disorder and Suicide

Multiple studies show a correlation between heavy drinking, alcohol use disorder, and suicidal ideation and attempts. This is even more so for those with an alcohol use disorder and depressive disorder. The amount of alcohol consumed makes a difference. One study produced results in which 4,000 current drinkers reported suicidal ideation and 716 reported making attempts on their own lives.⁸

Suicide risk factors increase if someone with an alcohol use disorder also misuses prescription or illicit drugs. If the number of substances increases, so do the risks for suicidality. For example, someone with an alcohol use disorder, opioid misuse, and nicotine addiction is more likely to experience suicidality than someone with only an alcohol use disorder. Psychiatric disorders may also contribute to the increase in risk if combined with polysubstance use disorders.⁹

Withdrawal from Alcohol and Suicide

If you are dependent on alcohol, you may experience withdrawal symptoms when you stop drinking alcohol. Withdrawal symptoms, including seizures, can range from mild to severe. They can also bring about more intense mental health symptoms such as depression and anxiety, leading to thoughts of ending your own life.¹⁰

Alcohol dependence, alcohol use disorder, and misuse cause medical and psychological hardships, such as seizures, lowering the quality of life. If circumstances do not improve, you might begin to consider and imagine taking your own life. You might even start to plan or follow through with an attempt on your life.¹⁰

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How to Find Help

If you, or someone you know, has an alcohol use disorder, suicidality, or both, help is available. There are many resources, including the National Suicide Prevention Lifeline (1-800-273-8255, also 1-800-273-TALK) and the Crisis Text Line (Text HOME at 741741).

Copy these numbers in a safe place, such as your cell phone contacts, so you can quickly dial for help if needed. Also, store local resources like the mobile crisis response team. You don’t have to wait to call someone. Whether you have fleeting thoughts or plan to end your life, someone is available 24/7.

The initial call for help can lead to mental health and substance use treatment, working with therapists who can implement behavioral therapies to help you overcome alcohol and suicide risk factors. For example, cognitive-behavioral therapies that first focus on stabilization and eliminating anything that threatens your life, such as:¹¹

Dialectical behavioral therapy (DBT)
Socio-cognitive-behavioral therapy (SCBT)
Attempted Suicide Short Intervention Program (ASSIP)
Collaborative Management of Suicidality (CAMS)

Guidelines for Alcohol and Suicide Assistance

As a concerned outsider or loved one, the most important thing to remember is that anytime is a good time to reach out for help. If you know someone who misuses alcohol and might have suicidal ideation, look for signs of suicidality, including:¹²

Talking about thoughts, plans, or attempts to end their life
Withdrawing from friends and family
Participating in activities that could lead to death, including increased alcohol misuse
Saying goodbyes to friends and family
Giving away essential items to specific friends or family

While there are many other signs, these are common. However, any noticeable changes in their mental or physical health are reason enough to talk with them and show them you care.

If you suspect someone may be thinking of taking their life, there are things you can do to prevent it:¹²

Ask them directly if they are thinking about suicide or have plans to take their life.
Keep them safe and away from anything they could use to follow through with their plan.
Be there for them physically and emotionally and avoid discounting their feelings.
Make the call for help with them.
Follow up to see how they are progressing.

When they are ready to receive the benefits of working with a professional treatment team, call 800-948-8417 Who Answers? at any time. You will speak with a specialist who can connect you with the right treatment program.

Resources

Conner, K.R. & Bagge, C.L. (2019). Suicidal Behavior: Links Between Alcohol Use Disorder and Acute Use of Alcohol. Alcohol Research: Current Reviews, 40(1).
Substance Abuse and Mental Health Services Administration. (2016). Substance Use and Suicide: A Nexus Requiring a Public Health Approach.
Rizk, M. M., Herzog, S., Dugad, S., & Stanley, B. (2021). Suicide Risk and Addiction: The Impact of Alcohol and Opioid Use Disorders. Current Addiction Reports, 1-14.
Lipari, R., Piscopo, K., Kroutil, L.A., & Miller, G.K. (2015). Suicidal Thoughts and Behaviors Among Adults: Results from the 2014 National Survey on Drug Use and Health (NSDUH). Substance Abuse and Mental Health Services Administration.
Caetano, R., Kaplan, M. S., Huguet, N., McFarland, B. H., Conner, K., Giesbrecht, N., & Nolte, K. B. (2013). Acute Alcohol Intoxication and Suicide Among United States Ethnic/Racial Groups: Findings from the National Violent Death Reporting System. Alcoholism, Clinical and Experimental Research, 37(5), 839-846.
Glasheen C, Pemberton MR, Lipari R, Copello EA, Mattson ME. (2015). Binge Drinking and the Risk of Suicidal Thoughts, Plans, and Attempts. Addiction Behavior, 43:42-9.
Lamis, D. A., Malone, P. S., & Jahn, D. R. (2014). Alcohol Use and Suicide Proneness in College Students: A Proposed Model. Mental Health and Substance Use: Dual Diagnosis, 7(1), 59-72.
Sung, Y. K., La Flair, L. N., Mojtabai, R., Lee, L. C., Spivak, S., & Crum, R. M. (2016). The Association of Alcohol Use Disorders with Suicidal Ideation and Suicide Attempts in a Population-Based Sample with Mood Symptoms. Archives of Suicide Research: Official Journal of the International Academy for Suicide Research, 20(2), 219-232.
Lynch, F. L., Peterson, E. L., Lu, C. Y., Hu, Y., Rossom, R. C., Waitzfelder, B. E., Owen-Smith, A. A., Hubley, S., Prabhakar, D., Keoki Williams, L., Beck, A., Simon, G. E., & Ahmedani, B. K. (2020). Substance Use Disorders and Risk of Suicide in a General US Population: a Case-Control Study. Addiction Science & Clinical Practice, 15(1),14.
Michel K. (2021). Suicide Models and Treatment Models Are Separate Entities. What Does It Mean for Clinical Suicide Prevention?. International Journal of Environmental Research and Public Health, 18(10), 5301.
Gutmane E, Suna N, Tomilova A, Liepina L, Folkmanis V, Karelis G. (2018). Alcohol-Related Seizures May Be Associated with More Severe Depression, Alcohol Dependence Syndrome, and More Pronounced Alcohol-Related Problems. Epilepsy Behavior, 91:81-85.
National Institute of Mental Health. (2021). Suicide Prevention.