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People with substance use disorder are at a significantly higher risk of both attempting suicide and dying by suicide, according to a study from Karolinska Institutet published in the journal Molecular Psychiatry.

The study also shows that the risk of suicidal behavior is elevated among relatives of people with substance use disorder, particularly close relatives.

In the study, researchers analyzed data from Swedish national registers covering just over 4.2 million people born in Sweden between 1958 and 1999. The participants were followed from 1973 to 2020. The researchers investigated the link between substance use disorders—that is, problematic use of alcohol or drugs—and suicidal behavior, defined as suicide attempts or death by suicide.

Of the approximately 258,000 people diagnosed with a substance use disorder, 23% had attempted suicide or died by suicide. The corresponding proportion among people without such a diagnosis was 1.5%. The highest prevalence was among people with both alcohol and drug dependence: 44% had experienced a suicidal event.

After the researchers accounted for factors such as gender, year of birth, socioeconomic circumstances and other psychiatric diagnoses, a clearly elevated risk remained. People with substance use disorder had more than six times the risk of suicidal behavior compared with those without the diagnosis. The risk was highest for those with both alcohol and drug dependence.

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