Co-Occurring Disorders: The Connection Between Mental Health, Substance Use, and Suicide
Suicide is the twelfth leading cause of death in the United States. In 2020, 45,979 Americans died by suicide—that’s one death every 11 minutes—with an estimated 1.2 million attempted suicides the same year. These staggering statistics are a stark reminder of why we must build awareness around risk factors, prevention, and recovery methods that can help with some of the associated co-occurring disorders of mental health and substance use issues commonly associated with thoughts of suicide and self-harm.
Mental health disorders play a significant role in suicide risk. According to the CDC, about 46 percent of people who died by suicide had a known mental health issue. Depression is the most commonly reported mental health disorder associated with suicide, but schizophrenia, anxiety, and substance use disorders are all risk factors. Substance use, though, is closely tied to both depression and suicide.
When two or more disorders appear together frequently, they are considered co-occurring disorders. Mental health disorders and substance use disorders affect around 9.5 million people as of 2019. According to the CDC, these co-occurring disorders account for about 50 percent of people diagnosed with substance use disorders and about 20 percent of people diagnosed with any mental illness. With both conditions also affecting the likelihood of suicide attempts, people who suffer from both see an even higher risk for suicidal thoughts and self-harm.
Suicide Rates and Co-Occurring Disorders
Co-occurring disorders, or dual disorders, are a significant predictor of suicide attempts, and the COVID-19 pandemic has exposed this connection even more dramatically. According to the Research Triangle Institute, daily alcohol consumption increased by 27 percent between February 2020 and April 2020, with a reported 36 percent of people surveyed stating they surpassed safe drinking guidelines in April, compared to 27 percent in February. And more than 35 U.S. states reported an increase in opioid-related mortality at the same time. Unsurprisingly, mental health disorders, specifically depression and anxiety, were on the rise in the general population.
Addressing Suicide, Substance Use, and Mental Health
The risk of relapse caused by psychological pressures and environmental stressors demonstrates the need for preventative measures for people with past co-occurring disorders, as well as people who may be at risk for one or both of these disorders. The National Institute of Mental Health, in conjunction with the CDC and SAMHSA, has established a suicide prevention hotline (988) for people contemplating self-harm or suicide in order to help connect them to both immediate and long-term assistance with mental health concerns.
Likewise, the U.S. Department of Health & Human Services has developed a community response system to prevent, treat, and rehabilitate those with substance use disorders, specifically reducing substance overdoses. With the DOSE system, the CDC aims to give medical providers and the general public more information and support to prevent opioid misuse and overdose, one of the fastest-growing concerns in public health today. Along with public awareness and the removing stigma associated with substance use disorders, the CDC funds research programs to directly address opioid addiction and abuse.
And with the ever-growing connection between mental health, substance use, and suicide, there’s a cry from both health care providers and the public to find a way to prevent overdoses and suicides for those with single or dual diagnoses. One method is consistent drug screening as an accountability measure (p. 4 of the linked PDF) for people with past substance use disorders. But while most screening methods are invasive or unsanitary, drug patches are viable options for long-term screening without disrupting daily routines.
Reliable, Noninvasive, and Long-Term Accountability
For over thirty years, the PharmChek® Drugs of Abuse Sweat Patch has been a trusted method to trace substance use for courts, employers, and recovery programs. Today, it’s an even more valuable tool in the fight against the opioid crisis. With recent laboratory and technological advancements, PharmChek® now offers a fentanyl add-on for our existing Standard and Expanded Panels. This additional level of continuous monitoring provides a safe and noninvasive screening option for dual-disorder diagnoses or those with a high risk of relapse or suicide attempts to reduce the risk of substance-related overdose or death. In the fight against suicide, we must look to community support like the 988 Suicide and Crisis Line, mental health availability, and substance use accountability. None of these can stand alone to reverse the increasing trend of dual-diagnosis suicide deaths, but with emergency response, ongoing medical support, and a system for accountability, people suffering from substance use disorders and mental health diagnoses can find a path to peace.