Study finds acute alcohol misuse among suicidal people

June 19, 2014 by Sharon Hong
Credit: Kevin Casper/public domain

(Medical Xpress)—One-third of all suicides in the U.S. involve acute use of alcohol before the fatal attempt, according to a study led by UCLA social welfare professor Mark Kaplan. The researchers say the findings underscore the need to link suicide prevention and alcohol-control strategies.

The study is the first to compare use among those who committed with that of a nationally representative survey of non-suicidal adults in the United States. Its purpose was to provide estimates of the relative risk of suicide associated with drinking and heavy drinking occasions.

The report was published online June 12 by the Annals of Epidemiology.

The researchers found that alcohol was detected in nearly 36 percent of men and 28 percent of women who committed suicide. Additionally, a at or above .08 grams per deciliter—considered legally intoxicated in many states—was a potent risk factor for suicide across the age spectrum, and that people who committed suicide were four to 20 times more likely than others to have engaged in heavy drinking at any point in their lives. High levels of were also associated with the methods of suicide that are most likely to be fatal, such as shooting and hanging.

"The key finding is that the data showed is common among people who are suicidal," said Kaplan, a faculty member at the UCLA Luskin School of Public Affairs. "Those who drank, drank heavily in the hour before taking their lives. Fewer than half of those who were alcohol positive at the time of death had a history of alcohol-related problems."

The researchers also found relative gender parity among people who committed suicide with elevated blood alcohol levels—a surprising finding because men in general are more likely than women to drink and drink in excess. The report noted that one possible explanation is that women are more likely than men to commit suicide by poisoning themselves, and alcohol may be used as one of the poisoning agents in combination with other substances.

A particularly troubling finding was that nearly a quarter of all those who committed suicide under the age of 21 tested positive for alcohol at the time of death.

The report puts forth several recommendations for health professionals and policy makers, in particular for addressing the connection between and suicide among the underage population, including:

Using media popular with teens and younger adults, such as social media, to explain the connection between and the risk of suicide, and enlisting school personnel to help carry that message.

Increasing access to alcohol abuse treatment programs.

Enhancing the enforcement of restrictions on access to alcohol for minors.

Educating parents about the dangers of maintaining alcohol in the home, especially if it's not kept in locked cabinets.

In addition, Kaplan said, the findings should prompt workers to probe for when dealing with people who are suicidal.

The researchers used data from the National Violent Death Reporting System to identify those who had used alcohol or showed signs of intoxication before they committed suicide between 2003 and 2011. Population estimates of comparable use of alcohol were based on the National Epidemiologic Survey on Alcohol and Related Conditions.

Explore further: American Indians are at much greater risk of suicide following acute alcohol intoxication

More information: "Use of Alcohol Before Suicide in the United States." Mark S. Kaplan, Nathalie Huguet, Bentson H. McFarland, Raul Caetano, Kenneth R. Conner, Norman Giesbrecht, Kurt B. Nolte. Annals of Epidemiology - 26 May 2014 (10.1016/j.annepidem.2014.05.008)

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not rated yet Jun 20, 2014
The recommendations breach one of the most fundamental aspects of science, that of identifying causation.

Whilst a correlation is clearly in evidence in the study, no causation is established. It is simply assumed that the alcohol causes the behaviour rather than the suicidal ideation and depression is causing the individual to be attracted to excessive alcohol use or dual cause whereby a depressed and/or suicidal person is attracted to alcohol which actually amplifies the problem. In other words, the third possibility is that depression seeks alcohol which exacerbates the depression and suicidal ideation.

Note that there are three different research approaches depending on the direction and type of causation:
1) how to stop depressed people seeking alcohol;
2) how to stop anybody drinking excessively;
3) understanding why a depressed person would pursue a strategy that makes the condition worse.

A fundamental law of science is: 'Correlation is not Causation'.

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