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Breaking the Silence: Suicide and Addiction

By Melissa Rios, LADC-MH

Suicide. It’s a subject that no one likes to talk about. Yet suicide is a reality, especially for those struggling with addiction and mental illness. Data shows that suicide is the tenth leading cause of death in the Unites States, which means approximately 44,965 Americans die by suicide each year. Why? Who are these individuals? How can we prevent this from occurring?

First, it is important to note that every circumstance of suicide is different. Many times, there are numerous contributing factors rather than just one cause. Statistics show of those who die by suicide, more than 90 percent have a diagnosable mental or substance use disorder (SUD). People who misuse alcohol or drugs attempt to kill themselves nearly six times as frequently as people who do not abuse substances. Alcohol and other drugs cause loss of inhibition, escalate impulsive behavior and over time, lead to variations in brain chemistry. Alcohol and other drug use can be disruptive to relationships, which in turn results in loss of social connections and alienation or isolation.

There are many warning signs of suicidal ideation. As a clinician, I look out for three indicators: speech, behavior and mood. If an individual begins talking about being a burden to others, feeling trapped or feeling like they have no reason to live, then these are speech warning signs. It is important to note that this speech may not be as blunt or clear as we would think. Any time you are unsure of what an individual is saying or meaning, simply ask. Behaviors to look out for may include withdrawing from activities, isolating from friends and family, saying goodbye to people or giving away prized possessions. Mood warning signs include loss of interest, depression, rage, irritability or anxiety.

Three Factors of Suicidal Ideation

Three factors must be determined and examined regarding suicidal ideation include health factors, environmental factors and historical factors.

1. Health

Health factors that should be inspected include mental health disorders, substance use disorders and serious or chronic pain conditions.

2. Environmental

Environmental factors include things like stressful life events such as divorce, loss of job or death. Another environmental factor is exposure to another person’s suicide. This aspect is often overlooked because people frequently think that if someone has experienced the pain from losing a loved one to suicide then they would never commit suicide themselves.

On the contrary, the word “pain” is lost in the shuffle. Prolonged stressors are also incorporated into environmental factors, such as bullying, harassment, relationship problems and unemployment. Last but not least, we must determine if someone’s environment allows them access to lethal means such as firearms.

3. Historical

Historical factors simply include two important pieces: previous suicide attempts and family history of suicide attempts. Is suicide genetic? No. Suicide in and of itself is not genetic but studies show that depression is genetic. People who have first-degree relatives (for example a parent or sibling) who are diagnosed with depression appear to have double the risk of developing depression than people who do not.

Next Steps

So now what? Being aware of the warning signs, factors and information that contributes to suicidal ideation is just the first step. What can individuals do to help prevent someone from making the permanent decision to take their own life? The most important thing you can do is talk to the person and ask questions. Barriers to preventing suicide can sometimes be as simple as not asking the question or being unwilling to engage in conversation with someone who is struggling. As difficult as it may be, we must come out and ask, “Are you thinking of or planning to kill yourself?”

By getting to the point and being very clear in our questions, we can achieve the first step in attempting to help someone by defining what they are faced with and not assuming or being left with uncertainty. Next time you are faced with someone in despair be willing to ask the hard question. It may help save someone’s life.

If you or someone you know is having suicidal thoughts, please do not wait another moment to call the National Suicide Hotline at 800.273.8255. We can all help prevent suicide. The Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved one.

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About Melissa Rios:

Melissa Rios, LADC-MH is a dually licensed outpatient program director with Valley Hope.

About Valley Hope:

Valley Hope provides residential and outpatient addiction treatment services at 16 centers in Arizona, Colorado, Kansas, Missouri, Nebraska, Oklahoma and Texas. Since its founding in 1967, Valley Hope has helped more than 310,000 individuals overcome addiction to lead successful and productive lives in recovery. Learn more at