Impact of Suicide Among Alcoholics

Woman drinking alcohol

Alcohol is involved in over a quarter of all suicides, which equates to 7500 annually [1]. Suicide is 120 times more prevalent among adult alcoholics than the general population.  Alcohol abusers have higher rates of both attempted and completed suicide than non-abusers and more than 1/3rd of suicide victims used alcohol just prior to death.

Alcohol increases impulsivity and decreases inhibition. It can increase negative self-image and decrease self-esteem. With alcohol use deepens depression and social isolation.  Many suicide attempts occur during binge drinking and among those who are alcohol dependent, 18% complete suicide [1].

Risk Factors of Suicide Among Alcoholics

The main risk factors for suicide linked to alcohol is a personal loss such as a divorce, separation, or death, job issues, unemployment or financial loss.

History of abuse, trauma, violence and pain as well as previous history of suicidal behavior or self-harm behavior can play into suicide and alcohol use. Other factors include early onset of drinking, family history of alcoholism, access to firearms and legal or criminal justice problems [1, 3].

Brain Functioning in Those Who Attempt Suicide and Abuse Alcohol

Co-occurring alcohol abuse and mental illness also significantly increase suicide risk. Those who misuse alcohol and prescription drugs such as Oxycontin, Hydrocodone, or Adderall have 40 times greater risk of suicide [1].

Recent studies of the brain functioning in alcohol dependant adults have shown that it is associated with dysfunction in multiple neurotransmitter systems and alcoholics are at a significantly higher risk for suicide than individuals of the general population [2].

The main neurotransmitter involved with alcohol is the GABAergic, the serotonergic and the glutamatergic systems. Alcohol induced NMDA inhibition in the cerebral cortex results in the reduction of noradrenaline and acetylcholine, might be related to the development of depression [2, 8].

Reduced serotonin function has been identified in suicides and in alcohol dependent patients. Reduced serotonin was also found in individuals displaying aggressive and impulsive behaviors and was a predictor of both early onset alcohol use disorders and suicide attempts among alcoholics.

Intoxication can trigger self-harm behaviors, and can increase impulsivity and increased depressive thoughts and feelings of hopelessness, while removing internal barriers of hurting oneself.  Once a person has made the decision to attempt suicide, alcohol can serve several functions.

First, alcohol itself plays a role in determining how much a person will ingest, and may increase feelings of courage, numb fears, or anesthetize the pain of dying and behavior of suicide.

Secondly, alcohol can serve as a means to end as the suicide method itself. Individuals with substance use disorders are about 6 times more likely to commit suicide than the general population [3].

What is the Link Between Suicide and Alcoholism?

Suicide among those with untreated substance use disorders is as high as 45%. Stigma plays a role in keeping many individuals from seeking help. Research shows that in certain populations that commit suicide, including older adults and women, are likely to have seen a primary care provider in the year before their death [3].

Psychological issues due to excessive alcohol abuse is anxiety, depression, and suicide. From a study of 50 individuals who were alcoholics and completed suicide, seven non-acute clinical features were identified that appeared to be intimately linked to suicide.  These included:

  • Continued drinkingMan Struggling with Alcoholism
  • Major depressive episode
  • Suicidal communication
  • Poor social support
  • Serious medical illness
  • Unemployment
  • And living alone. [5, 6].

Four or more risk factors were found among the patients studied, indicating that these risk factors are true for those at a higher risk to abuse alcohol and attempt suicide.

The Centers for Disease Control and Prevention (CDC) 2009 study looked at alcohol intoxication among various ethnic groups. 24% of those who die from suicide showed evidence of alcohol intoxication [7].

Their study also found that in the descendants tested, alcohol was found in every population and age group, showing that alcohol and suicide prevention is important for every group.

Those Left Behind

Children of alcoholics are at an increased risk for substance abuse, conduct problems, anxiety disorders, and mood disorders. Parental substance abuse can underlie family issues such as divorce, spouse abuse, child abuse and neglect, welfare dependence and criminal behaviors [9].

Studies conducted at the Western Psychiatric Institute and Clinic of the University of Pittsburgh Medical Center showed that clients with addiction and depression are at a higher risk for suicidal and homicidal behaviors, poorer treatment outcomes and higher relapse rates.

Psychiatric News reported on a recent speech by the National institute on Drug Addiction Director, Dr. Nora Volkow, where she stated that once it was thought addicts sought drugs or alcohol because they were sensitive to pleasure inducing effects of dopamine, but now known that they seek drugs and alcohol due to wanting to increase dopamine in the brain [10].

Girl by the oceanThis helps explain addiction cravings, as addicts are more vulnerable to environmental triggers.

In conclusion, alcohol increases the rate of suicide due to reduced inhibition, lack of feelings due to alcohol effects, and increased feelings of hopelessness and depressive symptoms.

It can impact families with the grief and loss of a loved one, the shock of the behavior, and financial burdens left behind by those who have completed suicide. Further education, outreach, and reduction of stigma can help individuals with alcohol and depressive symptoms receive treatment.

 


Image of Libby Lyons and familyAbout the Author: Libby Lyons is a Licensed Clinical Social Worker and Certified Eating Disorder Specialist (CEDS). Libby has been practicing in the field of eating disorders, addictions, depression, anxiety and other comorbid issues in various agencies. Libby has previously worked as a contractor for the United States Air Force Domestic Violence Program, Saint Louis University Student Health and Counseling, Saint Louis Behavioral Medicine Institute Eating Disorders Program, and has been in Private Practice.
Libby currently works as a counselor at Fontbonne University and is a Adjunct Professor at Saint Louis University, and is a contributing author for Addiction Hope and Eating Disorder Hope. Libby lives in the St. Louis area with her husband and two daughters. She enjoys spending time with her family, running, and watching movies.


References:

[1] http://www.mces.org/pages/suicide_fact_alcohol.php
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2872355/
[3] https://www.psychologytoday.com/blog/real-healing/201402/suicide-one-addiction-s-hidden-risks
[4] http://www.alcoholism-statistics.com/alcoholism-suicides-statistics/
[5] http://jamanetwork.com/journals/jamapsychiatry/article-abstract/495748
[6] file:///C:/Users/libby/Downloads/796725.pdf
[7] http://www.medscape.com/viewarticle/704837
[8] http://www.webmd.com/depression/guide/alcohol-and-depresssion#1
[9] http://www.dualdiagnosis.org/resource/depression/
[10] https://www.usnews.com/opinion/blogs/policy-dose/2015/06/01/america-is-neglecting-its-addiction-problem


The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Addiction Hope understand that addictions result from a combination of environmental and genetic factors. If you or a loved one are suffering from an addiction, please know that there is hope for you, and seek immediate professional help.

Published May 1, 2017
Reviewed By: Jacquelyn Ekern, MS, LPC on April 30, 2017.
Published on AddictionHope.com

About Jacquelyn Ekern, MS, LPC

Jacquelyn Ekern founded Addiction Hope in January, 2013, after experiencing years of inquiries for addiction help by visitors to our well regarded sister site, Eating Disorder Hope. Many of the eating disorder sufferers that contact Eating Disorder Hope also had a co-occurring issue of addiction to alcohol, drugs, and process addictions.