# Alcohol Use Associated with Suicide



## Daniel (Jun 18, 2009)

Alcohol Use Associated with Suicide
By Kristina  Fiore, _MedPage Today_
Reviewed by Robert Jasmer, MD

_*Nearly a quarter of all patients who committed suicide had a blood alcohol level above legal limits, and the percentage was highest among Alaska Natives/American Indians, followed by Hispanics.
*_ 
LITTLE FALLS, N.J., June 18 -- Alcohol plays a significant role in suicide, especially among Hispanics and American Indian and Alaska Natives, according to new data from the CDC. 

                Nearly a quarter of all patients who committed suicide had a blood alcohol level above the legal limit for driving a car, Alex Crosby, MD, of the CDC's National Center for Injury Prevention and Control, and colleagues, reported in the June 19 issue of Morbidity & Mortality Weekly Report.                

The percentage of suicides with high blood alcohol levels was greatest among American Indian/Alaska Natives at 37%, followed by 29% for Hispanics -- findings that hold implications for culturally specific intervention programs, Dr. Crosby said. 

"Alcohol is connected to suicides across all [racial and ethnic] groups," he said. "When programs try to address suicide prevention, they should definitely include alcohol as one component." 

The findings aren't a surprise, since alcohol is a known risk factor in suicide, said Eric D. Caine, MD, chair of psychiatry at the University of Rochester Medical Center. 

But the study is unique because it examines the role of alcohol in suicides across all ethnic groups -- data that has been limited in prior studies, Dr. Crosby said. 

"This is a really important paper because it underscores how much a common risk factor such as drinking contributes to something like suicide," Dr. Caine said. "Here's more data on how something like alcohol is fuel on the fire, and we need to ask ourselves what we are going to do about it." 

To examine the relationship between alcohol and suicide among racial and ethnic groups, the researchers looked at data from the National Violent Death Reporting System from 2005 through 2006. 

There were a total of 18,994 suicides in the 17 states that contributed to the database, and about 70% of those who committed suicide had been tested for alcohol. 

Among those, the overall prevalence of alcohol intoxication was about 24%, and the highest percentage occurred among American Indian/Alaska natives, then Hispanics, and among patients of all ethnic groups between 20 and 49 years old (28%). 

Alaska Natives/American Indians who committed suicide had the highest percentage of alcohol dependence and blood alcohol levels above 0.08 g/dL. 

Also, researchers found a significantly higher percentage of men with blood alcohol concentrations above 0.08 g/dL than women in all populations except among Alaska Natives/American Indians. Their percentages were equal (P<0.02).               

The results indicate that "many populations can benefit from comprehensive and culturally appropriate suicide prevention strategies," Dr. Crosby said. 

He said there are few interventions that target minorities, although such programs are increasing.               

"This is an invitation for public health approaches," Dr. Caine said. Since drinking considered ordinary behavior, one of the major challenges is taking something that's so common and building a prevention program around it, he said. 

He noted that the authors highlight two approaches -- alcohol taxes and higher blood alcohol content regulations for driving.               

"We don't necessarily think of those measures as suicide prevention measures, but on the other hand, they may well be," Dr. Caine said. "These are broad social policies, but this study underscores how they can be tied to something like suicide. We have to think about that." 

Some of the mechanisms linking alcohol to suicide include its effects on the nervous system and behavior, the researchers said.               

* "It can increase impulsivity, impair judgment, can have a dis-inhibitor effect on people," Dr. Crosby said. "It can increase feelings of hopelessness and depression." 
* 
* "If you're depressed, it makes your depression worse," Dr. Caine said, "and if you're not depressed, you may become depressed."                
* 
The study was limited in that it may underestimate alcohol use and the number of deaths among ethnic populations because of misclassifications. 

Also, the study is limited in generality because it is not nationally representative, with data from only 17 states.
_
Source reference:_
Crosby AE, et al "Alcohol and suicide among racial/ethnic populations -- 17 states, 2005-2006" MMWR 2009; 58(23): 637-41.


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## Charity (Jun 19, 2009)

I wonder now as I've wondered often before... How many of these people committed suicide under the influence of alcohol when they might not have if sober-- and how many of them had already decided to do it-- they just got really drunk first so as to make it easier?

I only wonder about this because though it seems like the alcohol might impair their judgment and cause them to do what they wouldn't normally, I know from my own bad thoughts that if I were ever to do that, I'd first want to dull my mind first as much as possible to make it less painful and traumatic.


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## Daniel (Jun 19, 2009)

> and how many of them had already decided to do it-- they just got really drunk first so as to make it easier?


Yeah, that question was raised in another article about this study, only to say there is no way to tell from the current data.  

Of course, most suicide attempts are fortunately aborted or are otherwise unsuccessful, so a similar question which is also currently unanswerable is how many people who aborted their suicide attempts were intoxicated or not at the time.


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## David Baxter PhD (Jun 23, 2009)

*Almost Quarter of Suicides Involve Intoxication*

Almost Quarter of Suicides Involve Intoxication 
By Steven Reinberg, HealthDay
Thu Jun 18, 2009

Almost 25 percent of people who take their own lives are intoxicated when they commit the act, U.S. health officials report.

From 2001 to 2005, there were an estimated 79,646 alcohol-attributable deaths each year and some 5,800 of those deaths were associated with suicide, according to the U.S. Centers for Disease Control and Prevention.

"This is the first study that shows alcohol is connected to suicide in a number of population groups," said report author Dr. Alex Crosby, a medical epidemiologist in the division of violence prevention at the CDC's Injury Center. "There are some groups that may be at greater risk for alcohol being related to a suicide event."

Other studies have shown that alcohol is a risk factor for suicide, Crosby added.

The report is published in the June 19 issue of the CDC's _Morbidity and Mortality Weekly Report_.

To reach its conclusions, Crosby's team used data from 17 states, sourced from the National Violent Death Reporting System for the years 2005 and 2006. They studied the relationship between alcohol and suicide in different racial/ethnic groups.

The researchers found that, overall, 23.6 percent of suicides involved alcohol intoxication. The highest prevalence was among American Indian/Alaska Natives (37.1 percent), Hispanic/Latino (28.7 percent) and those aged 20 to 49 (28.2 percent).

In addition, men were more likely to be intoxicated when they took their lives compared with women, Crosby said.

He noted that including alcohol and substance abuse in suicide prevention programs could help identify those at risk for suicide.

"Alcohol is linked to suicide in a large proportion of suicide events, and there are steps that communities can take to try and make sure that suicide prevention activities address the issues of alcohol in their programs," Crosby said. "When suicide prevention programs are developed, they should include alcohol as one of the aspects of the program to incorporate."

Dr. David L. Katz, director of the Prevention Research Center at Yale University School of Medicine, said the study sheds light on how alcohol and suicide interact.

"The depression that results in suicide may result in drinking," Katz said. "Perhaps the suicide decision is made first, and the alcohol follows to numb the pain, or perhaps alcohol truly does convert passive despondency into desperate acts. If so, it is a contributor, not an essential cause -- since the majority of suicides do not involve alcohol."

Both depression and alcohol abuse are significant public health problems, Katz said. "The mixture is highly volatile, and potentially fatal. Diligent, ongoing efforts to find and treat depression, and to prevent excessive alcohol intake are needed so the two collide less often."

*More information*
For more information on suicide, visit the U.S. National Library of Medicine.


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## Retired (Jun 26, 2009)

*Suicide & Alcohol Abuse - Deadly Duo*

*Deadly Duo: Suicide Linked With Alcohol Abuse*
Janis Kelly

June 24, 2009 ? Suicide is linked to alcohol intoxication across a broad range of ethnic groups, according to data from 17 states reported in the Centers for Disease Control and Prevention's (CDC's) June 17 issue of Morbidity and Mortality Weekly Report (MMWR).

About 24% of those who die from suicide show evidence of alcohol intoxication, including 37% of American Indian/Alaskan Native suicide deaths, 29% of Hispanic suicide deaths, and 28% of persons aged 20 to 49 years. The lowest percentage was 7% in non-Hispanic blacks.

"The most important finding is that among the decedents tested, alcohol was found in every population and age group," lead author Alex E. Crosby, MD, from the CDC's National Center for Injury Prevention and Control, in Atlanta, Georgia, told Medscape Psychiatry. "Health disparities need to be addressed, but alcohol misuse is an important issue for every group. The findings suggest that suicide-prevention efforts should include components that focus on alcohol problems. This isn't a new idea, but one that needs to be reinforced."

The researchers analyzed data from the National Violent Death Reporting System (NVDRS) for 2005?2006, which showed that nearly 24% of the 70% of suicide decedents tested for alcohol had blood alcohol concentrations at or above the legal limit of 0.08 g/dL, indicating that they were intoxicated at the time of death.

The MMWR editors note that mechanisms that might link alcohol use and suicide include "alcohol's effect on promoting depression and hopelessness, promoting disinhibition of negative behavior and impulsivity, impairing problem solving, and contributing to disruption in interpersonal relationships." They also noted that racial/ethnic differences in the prevalence of problem drinking do not explain the pattern of alcohol-associated suicides.

*Comprehensive Suicide-Prevention Programs Needed *

The researchers argue that these data highlight an ongoing need for comprehensive suicide-prevention programs.

"There are several types of programs that have been successful in reducing suicides that relate to alcohol," Dr. Crosby said. "First, there are comprehensive suicide-prevention programs. They are comprehensive in the sense that they include multiple components such as training community members to respond to persons in crisis, notifying mental-health professionals in the event of a crisis, and providing health education in the schools and community."

Other program components include outreach to families after a suicide or traumatic death, immediate response and follow-up for reported at-risk persons, alcohol and substance-abuse programs, community education about suicide prevention, and suicide-risk screening in mental-health and social-service programs, he added.

"Second, there are alcohol-specific interventions that have shown an effect on decreasing suicide," he said. "These programs include raising the minimum legal drinking age; increasing taxes on alcohol sales; limiting the sale of alcohol products by age or time of day on certain businesses; and mandating that workplaces be alcohol-free."

Sociologist and substance-abuse specialist Philip A. May, PhD, professor of sociology and family and community medicine at the University of New Mexico's Center on Alcoholism, Substance Abuse, and Addictions, in Albuquerque, commented, "Alcohol involvement with suicide is nothing new, especially with acute, impulsive suicides among younger people, especially males (eg, less than 35 years). I don't think that it can be effectively addressed via alcohol policy per se but should be approached within the mental-health arena, especially with clinicians and families being especially aware of the link between alcohol and self-destruction."

He and colleagues are developing a public-health approach to suicide prevention in an American Indian tribal nation.

Morbidity and Mortality Weekly Report. 2009;58:637-641.


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## Roy H. (Aug 18, 2009)

I threatened to kill myself after my girlfriend decided she was through with me last year. I was four times (BAC of .32) the legal limit and threatened to my sister I was going to harm myself. Cops were called and I was hauled off to the behavioral unit at a hospital downtown. Yeah, that was a rough time, as my life still is.


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## Fiver (Aug 18, 2009)

Yeah, but think of the money you're going to make from the screenplay you'll write one day.


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