Suicidal Ideation & Addiction | Symptoms, Risk Factors, & Treatment

Manish Mishra, MBBS

Medically Reviewed By: Manish Mishra, MBBS

on July 28, 2023

Suicidal ideation is a serious and treatable mental health concern that can be intensified by a pattern of harmful alcohol or drug abuse. When a person with a substance use disorder (drug addiction) is also experiencing suicidal impulses, dual diagnosis care is strongly recommended.

While the vast majority of those who have suicidal thoughts never participate in any suicidal planning or activity, suicidal thoughts remain a significant risk factor for suicide attempts. 

Likewise, drug and alcohol abuse can erode a person’s mental and behavioral health, leading to an increased risk of suicide death over time.

Because of this combination, those who are struggling with a substance use disorder (SUD) and suicidal inclinations are strongly advised to seek professional dual-diagnosis addiction treatment services.

Suicidal Ideation Background & Symptoms

Suicidal ideation is defined in the DSM-5 as, “thoughts about self-harm, with deliberate consideration or planning of possible techniques of causing one’s own death.” 

This is considered to be separate from passing, momentary, or intrusive thoughts of death or suicide, which are far more common.

Suicidal ideation is not a mental disorder in its own right, but rather a symptom of other psychiatric disorders, though some people may experience suicidal ideation without experiencing another mental disorder, usually in response to some negative life event or traumatic experience.

Suicidal ideation is also sometimes subdivided into two different forms:

  • passive suicidal ideation, which involves thinking about not wanting to live or imagining being dead
  • active suicidal ideation, which involves preparation to die by suicide or forming a plan to do so

In either case, suicidal ideation is a serious but treatable condition that can be evidence of an untreated psychological disorder. Resolving these feelings and their causes can greatly improve an individual’s overall personal wellness and life satisfaction.

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Symptoms Of Substance Use Disorder

Many people abuse legal substances like alcohol, prescription drugs like opioids, amphetamines, and benzodiazepines, and illicit drugs like heroin/fentanyl, methamphetamine, and cocaine. 

Substance abuse can begin and continue for reasons like recreation, social enhancement, or self-medication against psychological or physical pain.

Substance abuse may then progress to become a substance use disorder (SUD) when a person loses the ability to control or manage use despite it causing noticeable problems in physical or mental health, relationships, finances, and more.

Other warning signs of a developing SUD include:

  • increasing drug/alcohol tolerance
  • experiencing drug cravings
  • experiencing withdrawal symptoms between doses
  • experiencing behavior or personality changes related to substance abuse
  • mood and mental health decline, often including impulsivity, anxiety, and depression
  • dangerous/high risk substance abuse 

Risk Factors For Co-Occurring SUD & Suicidal Ideation

Suicidal ideation and SUD are mutual risk factors and comorbidities.

For example, those struggling with substance abuse are at a significantly greater risk of suicide than the general population. Likewise, those struggling with a traumatic event or serious psychological disorder may eventually engage in a high-risk pattern of substance abuse.

Specific mood disorders and mental illnesses associated with both SUD and suicidal ideation include:

Other predictors for these two conditions may include:

  • chronic pain and serious health issues
  • traumatic childhood experiences or recent traumatic events
  • criminal and legal issues
  • lack of a healthy support system
  • poor access to mental or physical healthcare resources

Dual Diagnosis Treatment For Co-Occurring Suicidal Ideation & SUD

Dual diagnosis treatment programs provide effective care and support for those with both a substance use disorder and other mental illness, including suicidal ideation. 

In these programs, providers work closely with participants to develop an individualized treatment plan that may feature a combination of:

Psychotherapy/Behavioral Therapy

Different forms of psychotherapy (talk therapy) and behavioral therapy are commonly used to address mental and behavioral health disorders, including substance use disorder and other mental health disorders associated with increased suicide rates.

Some examples to note include:


Medications may also be used as part of dual diagnosis treatment programs. 

These can include antipsychotic medications for schizophrenia or other psychotic disorders, anxiety medications, antidepressants, sleeping medications, and medications like methadone, buprenorphine, or naltrexone which are FDA-approved for the treatment of opioid/opiate or alcohol use disorders.

Peer Support

While isolation and feelings of abandonment are common among those with suicidal ideation and substance use disorder, having strong social connections, emotional support, and accountability are protective factors for suicide prevention as well as long-term SUD recovery.

This makes programs like AA and NA, as well as other peer support groups for anxiety, depression, and other mental illnesses, an important aspect of long-term recovery.


Professional aftercare services like employment counseling, sober living housing, case management services, and others can also help to ensure an individual has a more positive overall life experience after their primary inpatient care is completed.

Find Treatment In Ohio

We are a professional substance abuse treatment center and primary mental health services provider located in Northwest Ohio. We offer evidence-based treatment services, including:

  • medical detoxification
  • short- and long-term residential care
  • behavioral therapy
  • medication-assisted treatment options
  • case management
  • aftercare planning

If you or a loved one have been struggling with thoughts of suicide or suicidal behavior, increasing or unmanageable alcohol or drug use, or both conditions together, please reach out to us today.

  1. American Association of Suicidology
  2. Centers for Disease Control and Prevention (CDC)
  3. Substance Abuse and Mental Health Services Administration (SAMHSA)
  4. Substance Abuse and Mental Health Services Administration (SAMHSA)

Written by Ohio Recovery Center Editorial Team

© 2024 Ohio Recovery Center | All Rights Reserved

* This page does not provide medical advice.

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