The Overlooked Link Between Suicide, Alcohol, and Other Drug Use

 

Understanding Suicide Risk and Alcohol Use

It is well established that suicide is a complex phenomenon influenced by multiple factors. However, the role of alcohol and other drug (AOD) use is consistently underestimated, despite clear evidence identifying substance misuse as a significant driver of suicide risk. Understanding this intersection is critical for professionals, workplaces, and support networks aiming to intervene early and prevent loss of life.

The Evidence – Alcohol and Drug Use as Suicide Risk Factors

Research demonstrates that individuals with AOD disorders are at significantly increased risk of suicide. According to the World Health Organization (WHO) (2022), harmful alcohol use is a causal factor in over 200 diseases and injury conditions, including suicide. Notably, the Australian Institute of Health and Welfare (AIHW) reports that alcohol was present in nearly one-third of suicide deaths in Australia (2023), confirming the scale of the issue.

In the UK, data from the Office for National Statistics (ONS) reflects similar patterns, with alcohol-related deaths contributing significantly to suicide rates. The National Institute for Health and Care Excellence (NICE) highlights substance misuse as a critical risk factor, particularly among young people aged 15–24.

Furthermore, the Black Dog Institute (2023) states:
“People with alcohol use disorder are eight times more likely to die by suicide. Failing to address substance use is failing to address suicide risk.”
Black Dog Institute – Alcohol and Suicide

It is important to note that substance use increases suicide risk not only through the exacerbation of mental health conditions but also by increasing impulsivity, lowering inhibition, and worsening feelings of hopelessness. As Professor Steve Allsop explains:
“Alcohol increases impulsivity and lowers inhibition—two of the most dangerous factors when it comes to suicide risk.”
SBS News

The Role of Trauma, Grief, and Complex Loss

It is common for individuals experiencing unresolved trauma or grief to turn to alcohol or drugs as a coping strategy. While initially offering temporary relief, substance use often perpetuates a cycle of avoidance, increased psychological distress, and eventual crisis.

The Australian Bureau of Statistics (ABS) (2023) reports that those with co-occurring mental health and substance use disorders are seven times more likely to die by suicide. Indigenous populations, veterans, and men over 45 represent particularly vulnerable groups, often facing compounded grief, trauma, and social isolation.

Why Substance Use Remains Underrepresented in Suicide Prevention

Despite the overwhelming evidence, there remains a persistent failure to address AOD use within suicide prevention strategies. Several factors contribute to this gap:

• Stigma: Addiction continues to be viewed as a personal failing rather than a health condition requiring clinical intervention.
• Cultural Normalisation of Alcohol Use: In Australia, the UK, and many western cultures, alcohol misuse is socially accepted, making early intervention difficult.
• Fragmented Service Systems: Mental health and AOD services often operate separately, creating barriers to effective support.
• Lack of Training: Health professionals and support workers frequently lack the skills to assess the intersection between substance use and suicide risk.

Recommendations for Practice and Prevention

 

Given the significant risks associated with AOD use, it is essential that suicide prevention approaches evolve to address this gap. The following recommendations are evidence-based and intended to strengthen prevention efforts:

1. Incorporate Substance Use Screening into Suicide Risk Assessments

Every suicide risk assessment, whether conducted in clinical, community, or workplace settings, must include direct questioning regarding alcohol and drug use. This ensures early identification and appropriate referral.

2. Deliver Trauma-Informed, Dual Diagnosis Support

Supporting individuals experiencing both mental health difficulties and substance use challenges requires an integrated approach. Dual diagnosis services must be accessible, trauma-informed, and stigma-free.

As Dr Mark Ferry, University of Melbourne, observes:
“Ignoring substance use when addressing suicide is like treating symptoms without ever looking for the cause.”
University of Melbourne

3. Build Capacity through Targeted Training

Workplaces, health professionals, and community support networks need tailored training to recognise the signs of harmful substance use and understand its role in suicide risk. This includes recognising the hidden signs of problematic use in everyday conversations.

4. Strengthen Community-Led and Culturally Safe Programs

Indigenous populations, in particular, require culturally responsive support systems that acknowledge the impact of historical trauma and grief.

Recognising the Warning Signs

Substance use as a risk factor for suicide is often visible if one knows what to look for. Warning signs include:

• Escalating use of alcohol or drugs
• Withdrawal from social connections
• Expressing feelings of hopelessness or being a burden
• Risk-taking or reckless behaviours
• Sudden mood changes or emotional dysregulation

Responding to these signs early can prevent escalation and save lives.

Practical Solutions – How I Can Support You or Your Organisation

If you or someone you know is struggling with alcohol use and its impact on mental health, I have developed “Breaking Up with Alcohol”—a practical, self-paced program designed to support people ready to reassess their relationship with alcohol.

This program provides tools grounded in clinical practice to help:

• Understand your personal triggers
• Develop healthier coping strategies
• Rebuild emotional regulation without alcohol

Learn more about the Breaking Up with Alcohol program here:
[Explore the Program]

For professionals, workplaces, and community groups, I also offer Mental Health First Aid (MHFA) training. MHFA provides accredited skills to recognise and respond to mental health crises, including those complicated by substance use.

Learn More About MHFA Training.

 

Conclusion

In summary, substance use is a critical but often ignored suicide risk factor. Alcohol and other drug misuse must be recognised not as a separate issue but as central to many suicide deaths. If we are serious about reducing suicide rates, we must embed this understanding into every level of assessment, service delivery, and policy.

The challenge lies not in a lack of evidence, but in the willingness to face what is often an uncomfortable truth: substance use, trauma, and suicide are deeply interconnected. Only through acknowledging this can we begin to implement prevention strategies that truly save lives.