Researchers followed more than 122,000 female youths for about three decades, starting when they were 8 to 19 years old. Overall, about 5,800 of them, or slightly less than 5 percent, had attempted suicide. During follow-up, women who had a history of attempted suicide were 5 times more likely to be hospitalized for a substance use disorder, researchers reported in JAMA Psychiatry. The odds rose with the number of suicide attempts, with three or more suicide attempts associated with 21 times the risk of substance use hospitalizations. While the risk of developing substance use disorders was highest over the first five years after a suicide attempt, these women remained at increased risk for even after 15 years or more had passed. How women attempted suicide also influenced their risk of substance use in the future. Jumping, for example, was associated with a roughly tripled risk of substance use hospitalizations, while the risk was at least 10 times greater for hanging, suffocation, or other violent means. Not all substances carried the same risk. Women with a history of attempted suicide were more than 30 times more likely to be hospitalized for misusing sedatives or hypnotic drugs, and more than 16 times more apt to misuse hallucinogens. By contrast, they had 9 times the risk of hospitalization for alcohol use disorder, and about 5 times the risk for opioid misuse. One limitation of the study is that it wasn’t designed to determine how a history of attempted suicide might directly cause substance use problems in the future. It’s also possible that some of the same underlying issues that contributed to the suicide attempt — such as mental illness, exposure to trauma, or a family history of suicide or substance use — also contributed to substance use disorders, the researchers point out. Suicide attempts can also exacerbate underlying depression or mental health conditions, which in turn make women more vulnerable to substance use disorders down the line, the researchers note. “The findings underscore the importance of screening youths for mental health conditions and suicidality,” the study team writes. “Adolescents who are admitted to the hospital after a suicide attempt frequently undergo emotional and psychosocial assessments, but few receive further psychotherapy after discharge,” they write. The study findings suggest that this needs to change.
