Managing life's challenges while balancing substance use and mental health difficulties can be hard. These difficulties can sometimes cause someone to have thoughts of suicide.

As many as 90% of those who have died by suicide have a diagnosable mental disorder at the time of their death while only 46% had been in treatment. Getting help for substance use and/or mental health can make improvements in one's quality of life as well as provide a protective factor against thoughts of suicide.

The Relationship Between Substance Use and Mental Health Is Complex

Substance use has an impact on mental health. It is a delicate balance and continued use can harm existing mental health concerns as well as be a trigger for creating new problems.

Self-Medicating – Many people seeking to reduce their symptoms turn to substances. This can often have the opposite effect, as using substances worsens symptoms over time. It is also common to confuse how self-medication impacts one's physical or mental health. Someone expecting a calming experience from self-medication might become more anxious, leading to more self-medication and worsening symptoms and overall health.
Chemical Imbalances – Substances can alter brain chemistry, leading to unexpected wide mood swings. Changes in brain chemistry can bring additional challenges to mental health care and treatment, and impact how one copes with life challenges. Sleep difficulties, including falling or staying asleep and emotional regulation, are common problems people have.
Increased Stress – Substance use and mental health difficulties can cause strains in many areas of one's life. This includes relationships, financial strain, and legal problems. Mental health symptoms can worsen because of this strain.

3 Mental Health Conditions Affected by Substance Use

Combining substance use with mental health disorders can have serious consequences. Often, reactions to substances when experiencing symptoms of a mental health concern can be unpredictable. Here are some examples of what can occur — however, remember that this list is not exhaustive.

Depression – Many substances have side effects which can make depression worse. Those experiencing depression can experience hopelessness when using substances.
Anxiety – Users of amphetamines, cocaine, hallucinogens, and others can experience a significant increase in anxiety, as depressants have been known to aggravate anxiety.
Psychosis – Managing psychotic symptoms is a delicate balance for those who experience them. Substance use can easily derail the progress that a person has made.

Someone experiencing depression or anxiety who uses substances might not recognize that it's the substance worsening their symptoms.

Substance Use and Suicide Risk

According to the Centers for Disease Control (CDC), suicide is a leading cause of death in the United States. Nearly 50,000 people died by suicide in 2022, and this number has been growing every year. Over 13 million people seriously considered suicide that same year.

Sometimes, people think of suicide when under the influence of substances even when they haven't considered it before. Those who are struggling with suicidal thoughts are at a much greater risk of attempting or dying by suicide.

Alcohol use has long been connected to suicide, with alcohol use disorder involved in 25% of deaths by suicide. On the other hand, deaths related to opiate use have skyrocketed in recent years. According to one research study, opioids were identified in 20% of recent suicide cases.

In the same study, a variety of other drugs have also been found in the systems of those who have died by suicide, including cannabis (10.2% of cases), cocaine (4.8% of cases), and amphetamines (3.4% of cases). Combinations of drugs and alcohol are also common. Specific data related to drug use varies, but approximately 40% of those who seek treatment for substance use have attempted suicide in the past.

3 Ways It Can Increase the Risk of Suicide

Impaired Judgement – Substance use can impact a person's judgment, leading them to overthink a situation, act impulsively before considering consequences, and reduce inhibitions that would otherwise prevent some actions.
Emotional Instability – Mood swings are a common result of substance use. A substance user can go from feeling elated to depressed very quickly, leaving them confused about how they feel and how to manage their emotions.
Access to Lethal Means – Overdose is a significant risk for substance users when experiencing thoughts of suicide. Firearms access is a significant risk due to their lethality, with more than half of all suicides in the United States having been by firearm.

Research has shown that there is an increased risk of suicide when using substances. Many people have died by suicide and many of those who have had a suicide attempt were under the influence at the time.

Sometimes people who are under the influence of alcohol or drugs attempt suicide when they otherwise would not consider it. Removing access to lethal means can save lives for those who are at risk of suicide.

4 Ways to Address the Dual Crisis of Mental Health and Substance Abuse

The best way to get help for both mental health difficulties and substance use is to get help for both at the same time. In the past, that was not the case. Today, it is standard practice to provide help and hope for those coping with mental health and substance use challenges.

Recovery is possible! Of the more than 30 million Americans who have experienced mental health and substance abuse issues, the U.S. Substance Abuse and Mental Health Services Administration reports that nearly 3 out of 4 of them are either in recovery or have overcome their struggles.

Combined Treatment – There are treatment programs available to help with both mental health and substance use challenges. Programs could be located through primary care providers or local resources like Your Hope Center and Mountain Safe.
Supportive Networks – Having a supportive family, friends, and peer groups on your recovery journey can be helpful. SpeakUp ReachOut and Mountain Strong offer local mental health-oriented peer groups in Eagle County. The RECONNECTED Recovery Peer Support and Advocacy Program serves individuals with alcoholism/SUD in Eagle County who want to seek recovery.
Education and Awareness – Learn, learn, and learn. You can access information about substance use and mental health from reliable sources. Create a toolkit for yourself that grows with you.
Prevention – Identify what's going on in your life that makes you consider using substances. Pay attention to what makes you anxious or depressed. Go back to your supports to establish protective circles around you to stay as healthy as you can.

Add more ideas to this list as you discover ways to help you stay healthy.

Moving Forward With Hope and Support

Help is available for those experiencing mental health difficulties, substance use concerns, and both combined. There are resources and tools to help manage the complexities of mental health difficulties and the use of substances.

It's important to address substance use and mental health difficulties at the same time. When both are being experienced, they are intertwined.

Professional support is available, from medical providers and counselors experienced in substance use and mental health. The 988 Lifeline is also available 24 hours a day. You can reach this important service by dialing or texting 988. The website, 988lifeline.org, also has a chat feature.

Seeking help is the first step. Always remember that recovery is possible.

Substance Use, Mental Health, and Suicide Risk