Drugs and suicide: link to recent loss.

Drugs and suicide: Link to recent loss

The death of a spouse, rejection by a romantic partner, even eviction from an apartment can push someone with a serious alcohol or drug problem to suicide, according to a report in the June ARCHIVES OF GENERAL PSYCHIATRY.

Yet people with mood disorders such as severe depression -- a group previously found to have an increased risk of suicide -- are less likely than substance abusers to kill themselves shortly after these types of stressful events, say psychiatrist Charles L. Rich of the State University of New York in Stony Brook and his colleagues. Substance abusers, suggest the researchers, are more vulnerable to stress caused by "interpersonal losses and conflicts."

The data, based on 283 suicides in San Diego County, Calif., between 1981 and 1983, may not readily apply to all populations, notes psychiatrist George E. Murphy of Washington University School of Medicine in St. Louis. "Nevertheless, interpersonal loss is strongly confirmed as a major and immediate risk factor for suicide in substance abusers," he writes in an editorial following the report.

The researchers made posthumous diagnoses of substance abuse, as well as mood disorders, after interviews with a suicide victim's family, friends, employers and physicians. Other sources included hospital, school and police records.

Murphy and his colleagues had previsously linked suicide in 20- to 30-year-olds to depression, alcohol abuse and drug abuse (SN: 10/11/86, p.228). The new analysis finds that 42 percent of the suicide victims in this age bracket who were substance abusers -- either with or without a mood disorder -- had undergone a stressful loss or conflict in the six weeks before taking their lives. In a group of suicides over the age of 30 with the same diagnoses, 38 percent suffered an interpersonal disturbance in their last six weeks.

The researchers found significantly fewer instances of recent loss or conflict among suicides of all ages with a mood disorder or depressive symptoms that did not add up to a diagnosis of "major depression."

Nearly 60 percent of all suicides were substance abusers, say the researchers, and 84 percent of those abused both alcohol and other drugs.

Clinicians should pay close attention to the suicidal thoughts of substance abusers and involve the patient's family and friends in treatment, Murphy says. A short stint in the hospital, he adds, "may be needed for a period of protection [after a recent loss] as well as for detoxification."