Risk Factors Identified for Suicidal Ideation in Substance Use Disorders

Suicide with pills
Suicide with pills
A new study examines a link between first-onset suicidal ideation and substance use disorders.

Key risk factors that may lead to first-onset suicidal ideation in patients with substance use disorders have been identified, according to results from a study published in the Journal of Psychiatric Research.

Researchers retrospectively analyzed data from the prospective National Treatment Improvement Evaluation Study, which examined publicly funded addiction treatment programs over 5 years. Data from a total of 2560 patients who were treated for substance use disorders and had no history of suicidal ideation or attempts were evaluated at baseline and one year later for indications of suicidal behavior. Several factors, including mental health indices, sociodemographic variables, substance use severity measures, and interpersonal factors were used to determine predictors of first-onset suicidal ideation.

After statistical analysis, investigators found that ongoing substance use problems (odds ratio [OR] 1.33; 95% CI, 1.04-1.70; P =.02), mental health problems (OR 1.54; 95% CI, 1.19-2.01; P <.01), and issues related to obtaining therapy for substance use problems (OR 1.90; 95% CI, 1.16-3.11; P =.01) were significant predictors of first-onset suicidal ideation. The results indicated that patients with ongoing substance use or mental health concerns were at highest risk for suicidal ideation.

The primary study limitation was the high-risk sample, which limits generalizability of results to other patient groups.

Related Articles

“Our findings indicate current distress relating to mental health and substance use, respectively, and difficulty adequately accessing treatment for substance use uniquely predicted first-onset suicidal ideation,” the researchers wrote.

“Future clinical work and research would benefit by addressing these issues, potentially by focusing on mental health treatment in substance abuse programs and evaluating barriers to treatment,” they concluded.


Walsh RFL, Sheehan AE, Liu RT. Prospective prediction of first lifetime onset of suicidal ideation in a national study of substance users. J Psychiatr Res. 2018;107:28-33.