How alcohol and substances influence suicidal thinking

A person’s struggle with mental health and suicide concerns rarely occurs in a vacuum. To tie in with National Drug and Alcohol Facts Week in the United States, we want to reflect on steps we can take when substance use is present alongside risk for suicide. 

The presence of substance use should prompt us to think differently about foreseeable changes for suicide risk. While someone might not be struggling with thoughts of suicide when they are not using substances, they may be more likely to experience such thoughts when they are.  

Substance use contributes to tunnel vision, which can make it hard for a person to see ways to escape their pain other than suicide. For this reason, it is important to consider increased use as a foreseeable change that can be planned for.  

It is crucial to work with both the individual and their support people to develop contingency plans that address this foreseeable change, both in terms of direct suicide risk and in terms of risk arising through returning to use.  

You could try saying: 

“We have identified that a foreseeable change that could quickly increase your risk is a fight with your partner. You have also told me that when you drink alcohol, you can become angry quickly. Can we make a plan together for what we can try if you start using alcohol again and start to feel upset?”

Or 

“You have shared with me that you are concerned about losing your home due to using your rent money to buy drugs. I also know from what you have told me that not having a place to live could make your suffering unbearable. Could we work together to map out what you would do if your home was in jeopardy?”