
- Vol 30 No 8
- Volume 30
- Issue 8
Clinical Implications of Substance Use on Suicidality Among Youths
Both the American Psychiatric Association and the American Academy of Child and Adolescent Psychiatry have identified substance abuse as a top risk factor for suicide in youths.
Both the
Data from the 2001 to 2009 Youth Risk Behavior Survey were used to analyze the correlation between lifetime use of 10 common substances of abuse (alcohol, cocaine, ecstasy, hallucinogens, heroin, inhalants, marijuana, methamphetamines, steroids, and tobacco) and 4 measures of suicidality (suicide ideation, suicide planning, suicide attempts, and severe suicide attempt requiring medical attention). The study controlled for multiple confounders, including sociodemographic factors and other health risk behaviors, such as depression, eating disorders, sexual activity, and interpersonal violence.
The key findings from the study indicate that:
1. A history of substance use is a strong and independent risk factor for adolescent suicide ideation, and plans, and attempts-even after controlling for sociodemographics and other risk factors, such as depression, eating disorders, and interpersonal violence.
2. Illicit substances (eg, heroin, methamphetamine, steroids, cocaine, inhalants, hallucinogens, ecstasy) have a higher association with sui-cidal thoughts and behaviors than do legalized substances, such as alcohol, tobacco, and marijuana. However, all substances were associated with an increased risk of suicide attempts (
3. Among all substances surveyed, heroin, followed by methamphetamines, have the strongest association with suicide ideation, planning, attempts, and attempts requiring medical attention. Steroids also have a relatively strong association with suicide attempts compared with other substances. Hallucinogens have a relatively strong association with suicide attempts that require medical attention compared with other measures of suicidality.
4. Adolescents who reported an increasing number of substances used in their lifetime had an increasing risk of suicide ideation, planning, attempts, and attempts that required medical attention (
These findings suggest that users of different types of substances may have different risk profiles for suicide and that certain drugs may have specific psychological and behavioral sequelae that further increase suicide risk.
The major clinical implication from the study is that gathering information about the lifetime number and types of substances used by an adolescent can inform the
Disclosures:
Y. Wong is a Researcher in the department of applied psychology and human development at the University of Toronto in Toronto. Dr S. S. Wong is a Resident in the department of psychiatry at Massachusetts General Hospital and McLean Hospital in Boston. Dr Goebert is Professor in the department of psychiatry at the University of Hawaii John A. Burns School of Medicine in Manoa. Dr Hishinuma is Professor and Associate Chair of Research in the department of psychiatry at the University of Hawaii John A. Burns School of Medicine. The authors report no conflicts of interest concerning the subject matter of this article.
References:
Wong SS, Zhou B, Goebert D, Hishinuma ES. The risk of adolescent suicide across patterns of substance use: a nationally representative study of high school students in the United States from 1999 to 2009. Soc Psychiatry Psychiat Epidemiol. 2013 Jun 7; [Epub ahead of print]. doi:10.1007/s00127-013-0721-z.
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Will Biology Tell Us All We Need to Know About Mental Disorder?about 12 years ago
Lithium’s Neuroprotective Effectsabout 12 years ago
Moonrise, Tanglewoodabout 12 years ago
Clinical Implications of Working With Patients on Parole or Probationabout 12 years ago
Issues in Treating Patients With Intellectual Disabilitiesabout 12 years ago
The Challenges and Rewards of Rural Psychiatryabout 12 years ago
Introduction: Disparities of Careabout 12 years ago
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