Washington: While the link between suicide and substance use is complicated, a new study has strongly linked the use of cocaine and alcohol together to suicide risk across the board.
The study of hundreds of suicidal emergency department (ED) patients from around the U.S. found that the significance of the link varied with age, gender and race. Across the board, however, the use of cocaine and alcohol together was a red flag.
The authors wrote that one unexpected finding was that, when examined independently, alcohol use had no significant association and cocaine use had a borderline significant association.
Led by Sarah Arias of Alpert Medical School of Brown University, the team examined 874 men and women who presented at one of eight emergency departments around the country between 2010 and 2012.
They found that although people in the study reported misusing many different substances, including marijuana, prescription painkillers, tranquilizers and stimulants, only cocaine and alcohol appeared to have a significant association with suicide risk.
Of the entire study population, 298 misused alcohol, 72 were using cocaine and 41 were using both. Specifically, of those using both, the chance of attempting suicide again was 2.4 times greater than among people in the study who were not.
They also found that substance misuse was less likely an indicator of suicide risk among whites and women. Older people, meanwhile, were more likely to have an association between substance misuse and suicide.
Women are not less likely to be suicidal, the researchers note. In fact, they were more likely than men to have reported prior attempts. But the data showed that substance abuse was less likely to be involved among women.
"We're on our way to trying to identify factors that can be used to better assess and identify people who are at risk for suicide, and ultimately I think this is a step in the right direction to get a better picture," she said. "Patients who have potentially comorbid alcohol and cocaine use may be at a higher risk. Findings like these can be useful for informing suicide risk assessment."
The study appears in the journal Crisis.
