Veterans with Substance Abuse Disorders More Likely to Commit Suicide by Violent Means

Of the more than 30,000 suicides that take place in America each year, approximately 20% of them are committed by veterans, according to the Secretary of U.S. Veterans Affairs (VA). It is well known that veterans face multiple mental health risks following combat duty—including depression, anxiety, post traumatic stress disorder (PTSD), substance abuse, homelessness, and suicide—and the risk rates have surged for current and returning Afghanistan/Iraq war military personnel. However, new data on veterans’ mental health has revealed an even more alarming statistic among this demographic. A U.S. study, which will be published in July issue of the Journal on Studies of Alcohol and Drugs, shows that veterans diagnosed with a substance abuse disorder who commit suicide are more likely to do so by violent methods than by nonviolent methods.

Suicide among veterans has risen drastically in recent years, but for those with substance abuse disorders, the risks are even higher. The study—led by Dr. Mark Ilgen, a clinical psychologist at the Ann Arbor VA Health Care System and assistant professor in psychiatry at University of Michigan in Ann Arbor—intended to discover risk factors associated with suicide among veterans with substance abuse disorders to help improve suicide-prevention efforts. Dr. Ilgen and his research team analyzed 854 VA patients with substance abuse disorders who died by suicide between 2002 and 2006 and compared them to a random group of 4,228 substance abuse VA patients who did not commit suicide during this time. Patients were considered to have a substance abuse disorder if they had received two or more diagnoses for the same substance abuse disorder between 1997 and 2001.

Even though these veterans are likely to have access to potentially lethal prescription medications due to their substance abuse disorders, more than 70% of them died by violent means, such as the self-discharge of a firearm, rather than drug overdose. On the other hand, those veterans who were suffering from more severe and chronic mental disorders were likely to have died by nonviolent suicide. Statistically, veterans who suffer from mental disorders including PTSD, bipolar disorder, personality disorders, schizophrenia, anxiety, depressive, or comorbid disorders have an increased risk of committing suicide by either violent or nonviolent methods, yet this new study reveals a stronger association with nonviolent suicide deaths for this vulnerable population. Also, veterans who were diagnosed with an opioid dependency or who were diagnosed with comorbid substance abuse disorders were more likely to commit suicide by nonviolent means. However, the overwhelming majority of suicides remained to be caused by violent means.

Usual predictors of suicide that the VA has recognized as early warning signs were more related to nonviolent suicide deaths, even though these types of deaths occur less often. According to this new data, the symptoms of those veterans suffering from substance abuse disorders are generally being overlooked. Other studies have also found that individuals suffering from substance abuse disorders are 10–14 times more likely to commit suicide than those who do not abuse substances. Now that violent suicide deaths have been identified as the prevailing method of suicide among substance abusing veterans, the VA must adjust its precautionary measures for avoiding suicide risk among this larger group of individuals. For example, access to lethal means may need to be reduced among these substance abuse patients, the same precautionary measure taken for patients of other psychiatric disorders.

Individuals suffering from a substance abuse disorder often experience other psychological or emotional disorders, including comorbid substance abuse disorders. These disorders cause multiple symptoms including difficulty with impulse control, angry outbursts, increased aggressiveness, irritability, insomnia, despondency, negative thoughts, and uncharacteristic behavior—all of which increase the risk of suicide. Veterans can be more susceptible to mental disorders than other demographic groups, and should be provided with the necessary health services they require.

According to the Associated Press, veterans who sought counseling or medical treatment for their mental health in 2007 were less likely to commit suicide than those who did not seek treatment. Veterans experiencing these symptoms can find help at their local VA facility. Find more information at www.va.gov.

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