Substance Abuse and Suicide - Term Paper Example

Substance abuse and suicide Insert Name Insert Grade Course Insert Tutor’s Name 9th May 2011 Introduction Substance abuse, both acute and chronic is a common risk factor for suicide. The disinhibiting and intoxicating effects of most psychoactive substances are major attributes. These combined with personal grief greatly increase the risk of committing suicide. Up to 70% of suicides are committed by the young people involved in alcohol or drug abuse. Australia and more than a dozen other developed countries have shown parallel increases in the rates of suicides related to substance abuse. The Commonwealth, Territory governments and the Australian state have sought opportunities to coordinate initiatives for drug abuse and suicide prevention. This is a reflection of the concern by these communities to curb the rise in alcohol and substance use among people. It is important to note that many people have poorly understood the mechanism behind the association between drug use and suicide. This relationship can be well evaluated when an individual understands the statistical association between drug abuse, alcohol and suicide. The risk factors for harmful drugs and suicide are often related and frequently overlap when it comes to their emergency settings. This shows the relationship between the developments of conditions such as depressive disorders resulting from underlying aetiological processes. Besides, drugs play an important role in increasing impulsivity and reducing inhibition at the time an individual is committing suicide. This essay will examine the relationship between drug abuse and suicidal behaviour as well as some of the intervention measures that have been put in place especially by the Australian authorities. Methodological issues Research on drug abuse and suicide has been carried out in several areas. The areas of concern and the methodology of this research are important in contextualizing the relationship between the findings from Western Australia Coronial and Toxicology data and the literature review. Current state of research Evidences from population and clinical studies shows the weight of harm associated with harmful levels of drug and alcohol use and its association with suicide. However, the aspect of this association still has considerable uncertainty. This is due to the fact that both suicide and substance abuse are issues that are personally sensitive (Parsons, 2009). With these, collecting valid and reliable data on the associated risks and prevalence becomes a huge problem. The illicit nature of harmful drugs and the perception as a social misfit in behavior makes it cumbersome for individuals to readily admit that they use them. In addition, substance abuse varies widely with suicidal behaviors. These variations and the issue of which aspects of suicide or drugs to focus on, complicate the studies being carried out on risk factors for suicide among users of specific drugs (Hall & Degenhardt, 2009). It poses a problem in generalizing findings from different studies. For instance, it becomes complicated to compare findings from intravenous drug use and completed suicide studies and those from studies on cannabis use and suicide ideation. These studies do not always distinguish between alcohol and other drug use or between use and dependence. Therefore, the results of populations studied as well as definitions used and the methodologies vary considerably depending on the research question. Types of studies Various study designs have been used to overcome the methodological challenges. These study designs take into account the strengths and limitations of the association between substance abuse and suicide. These study designs have been classified into three broad categories. Firstly, psychological autopsy is one of the study designs the research has taken. Psychological autopsy provides data on suicide collected not from the deceased but from living people. This data is retrospectively recorded. However, its limitation is that those who might have died without committing suicide are not compared in this investigation posing a difficulty of whether the risk factor is a casual contributor to suicide (Hall & Degenhardt, 2009). Secondly, case control studies bring a solution to the limitation found in the psychological autopsy study design (Hall & Degenhardt, 2009). This study with its interest based on particular risk factors, contrasts a group showing suicidal behavior with a representative group not exhibiting the behavior. These studies too have a limitation on how it retrospectively obtains its information about the exposure to risk factors. Thirdly, longitudinal studies offer possible mechanism and casual direction of how the various study designs vary and associate with each other. Definitions A number of key variables have been used in the analysis of substance abuse and suicide. The following definitions are important for the purpose of understanding this analysis. Young person This is a group of people or youth whose ages according to the categorization of the Australian Bureau of Statistics, range from 15-24 years. Substance use This refers to a regular or dependence use of drugs. It can also mean occasional or recreational use of drugs. It is important to note that it becomes substance abuse when the user uses it dependently and in a harmful way resulting into negative effects. Some of the negative effects of substance abuse are legal issues, withdrawal symptoms, ill health, financial problems, homelessness, dependence, family conflict and so on (Parsons, 2009). Opiates These are overarching groups of analgesics. ICD-9 Codes These are codes that classify international diseases. In ICD-9 Codes, ‘E’ is used to classify self-inflicted injuries and suicide. Illicit drugs In this analysis, illicit drugs are categorized into inhalants, hallucinogens, stimulants, opiates and cannabis. Toxicology This refers to an analysis conducted on post-mortem blood. In toxicology, over the counter drugs, illicit drugs, prescriptions and alcohol as well as other substances are screened. Stressors in these analysis stressors will refer to perceived or real events that cause an individual to commit suicide. It is important to note that stressors are supposed to have occurred between the first and twelfth month before the suicide (Parsons, 2009). Stressors can be drug use, unemployment, legal issues, death of other like spouse or parent, relationship issues and financial problems, sexuality issues and abuse as a child among others. Substance abuse and suicide One of the main contributing factors to an increase in the rate of suicide among many in Australia, particularly young adults, adolescents and women over the past five years, has been widely cited as the increased use of alcohol, illicit and licit drugs (Hall & Degenhardt 2009). Data derived from records obtained from hospital and health service records concerning Australian population level has been used to derive aetiological fractions of morbidities and mortalities use of alcohol and other drugs (Britton & Conner, 2010). In this study, opiates and alcohol were considered to be the only drugs that associated significantly and independently with suicide. For instance, in Western Australia, 13% of suicides were committed by males aged 15-24 years and 9% suicides with females of the same ages as the males attributable to alcohol use (Mishara & Weisstub, 2010).. Chronic dependent use of opiates and alcohol increases the rate of suicide. Suicide in this case will be as a result of direct effect of chronic alcohol problems and opiate dependence or indirect effects like poor physical health status, isolation and social deprivation arising from the same. Moreover, increased biological susceptibility to committing acts of suicide that have fatal outcomes is a result of acute effects of opiates or intoxication. Intoxication leads to direct depressive effects and impairing judgment (Hall & Degenhardt, 2009) A recent Coronial record study in Australia showed that at the time of death due to suicide, 43% of all male that died tested alcohol positive in their blood (Apter, 2010). Earlier on, a similar study found out that positive blood alcohol readings were taken and this added to up to 36% of suicides committed by people of all ages. Most of the people who had committed suicide had chosen to use carbon monoxide. In addition, other studies that have been taken include population and clinical studies and they too indicate that there is an association between suicide and dependency on alcohol and other drugs. Moreover, studies on case control have shown that in the whole population of Australia, suicidal behavior is higher among drug addicts and alcoholics (Britton & Conner 2010). This indicates that risk ratio for committing suicide is grossly elevated by dependence. Additionally, drug abuse greatly contributes to suicide. Regular use of a drug like cannabis presents to a vulnerable individual adverse effects. Acute usage of cannabis may lead to an act of suicide (Parsons, 2009). This could be due to cannabis intoxication that causes psychomotor and cognitive impairment. Alcohol intoxication bears similar attributes like cannabis intoxication. However, the question of whether cannabis intoxication has effects like accidental injury and suicide still remains. Cannabis ingestion usually has immediate and adverse effects that display themselves in symptoms like depression, panic and feelings of anxiety. In some individuals, cannabis dependency comes as a result of its long-term usage. This dependency may lead to suicide when it begins to present psychosocial, interpersonal and legal difficulties. Additionally, acute toxic psychosis can be produced if an individual becomes a chronic and daily user of cannabis. It is important to note that it is the half-life of delta 9 tetrahydrocannabinol (THC) that causes toxic psychosis (Apter, 2010). Eventually, what will take place is that there will be an accumulation of the levels of psychoactive components. The disruption to normal brain processes during the rapid remission of toxic psychoses at a time when an individual has abstained from use of cannabis may increase risks for accidental death, injury or suicide (Britton & Conner 2010). Studies show that the availability of potent strains of cannabis in an individual is likely to increase the prevalence of toxic psychoses. However, the hypothesis that the use of cannabis can cause persistence of either chronic or acute functional psychosis beyond the intoxication period is not supported. This is because of the difficulties of distinguishing the psychoses from schizophrenia (Parsons, 2009). Acute psychosis with predominant symptoms like hypomanic symptoms, agitation, anxiety, hallucination, delusion, amnesia and confusion has increased the risks for suicide among the indigenous populations (Hall & Degenhardt 2009). A finding by the Western Australia Child Health Survey indicated that among the adolescents of 12 -15 years, suicidal ideation was three times higher among the users of cannabis that those who did not. In addition, reported deliberate self harm and attempted suicide was 41% of those who used cannabis compared to 17% of those who did not use cannabis in the past six months (Apter, 2010). In Australia today, the use of cannabis among the young people is endemic. It paves way to the use of other drugs. In addition, it brings behaviors such as conduct disorder associated with increased suicide risks. Additionally, there are other illicit drugs that the Australian population uses. These drugs include methadone and heroine, synthetic hallucinogens or the LSD, amphetamines and opiates (Britton & Conner 2010). The drugs such as synthetic hallucinogens and amphetamines when used by vulnerable individual trigger latent psychosis. However, opiates elevate suicidal behavior and even suicide among its users. Others drugs like methadone and heroine have markedly increased the rates of death in Australia due to overdose (Parsons, 2009). Also, variation in purity of these drugs either due to polydrug or use of naltrexone has increased the fatalities. Most of the deaths in Australia among the addicts are unnatural deaths such as from homicides, accidents, suicides and drug overdoses (Hall & Degenhardt 2009). Intervention measures Many health organizations and the Australian government has put concerted efforts towards tackling the issues of harmful drug use and alcohol. These efforts are geared towards identifying treatment that is effective. Recently, experimental trials were undertaken to come up with a treatment that will be effective enough to prevent relapse (Apter, 2010). Also, efforts have been put to educate individuals on the importance of abstinence and reduction of harmful patterns of substance use. However, this is a difficult process as the norms and behaviors that communities, families and individuals have reinforces alcohol and other drug use (Britton & Conner, 2010). A number of prevention strategies have been brought up to create treatment programs that will help solve the problems of increasing demand for treatment and poor long-term outcomes of such treatments. The health system in Australia has come up with an evidence based kind of prevention strategy that targets risk factors for disorders. This strategy is efficacious in reducing psychosocial problems like depression, drug use and suicide by looking at the predisposing factors that may trigger disorder during the development of an individual (Hall & Degenhardt, 2009). In this prevention method, the risk factors, whether proximal or distal in an individual’s life, are looked into. There are a number of preventative methods that can be used (Glass, et al., 2010). These methods include primary, secondary and tertiary methods of prevention. In primary prevention, incidence reduction efforts are put to reduce occurrence of new cases. On the other hand, secondary prevention is done after the development of initial symptoms of disorder. It is doe to reduce incidence of occurrence of new cases. Additionally, tertiary prevention reduces complications arising by offering treatment and rehabilitation efforts. Conclusion To sum up, it is important that health-care officials and physicians recognize the high prevalence of alcoholism and drug abuse. It would be very difficult to predict suicide among individuals or even high risk groups using drugs. However, recognition of the risk factors and disorders as a result of drug use and alcohol will assist clinicians to come up with preventive interventions. Hospitalization, detoxification and rehabilitation are some of the methods that should be applied on substance abusers with recent suicide plans or those that have active plans for suicide. When these methods are applied to them, these alcohol and378535-Substance abuse and suicide assignment.doc drug abusers develop the ability to abstain. Additionally, there should be designed treatments aimed at resolving a major depression as well as enhancing support for abstinence. These will reduce the chances of suicide among substance users. References Apter, A. (2010). Suicidal Behaviour in Adolescence. Canadian Journal of Psychiatry. 55(5), 271-273.  Britton, P., & Conner, K. (2010). Suicide Attempts within 12 Months of Treatment for Substance Use Disorders. Suicide & Life-Threatening Behavior. 40(1), 14-21. Glass, J. et al. (2010). Inpatient Hospitalization in Addiction Treatment for Patients with a History of Suicide Attempt: A Case of Support for Treatment Performance Measures[dagger]. Journal of Psychoactive Drugs, 42(3), 315-325.  Retrieved May 2, 2011, from ProQuest Medical Library. Hall, W., & Degenhardt, L. (2009). The Australian Illicit Drug Reporting System: Monitoring trends in illicit drug availability, use and drug-related harm in Australia 1996-2006. Contemporary Drug Problems. 36(3/4), 643-661,377-378.  Retrieved May 3, 2011, from Research Library.   Mishara, B., & Weisstub, D. (2010). Resolving Ethical Dilemmas in Suicide Prevention: The Case of Telephone Helpline Rescue Policies. Suicide & Life - Threatening Behavior, 40(2), 159-69.  Retrieved May 4, 2011, from ProQuest Medical Library. Parsons, J. (2009). Not mission impossible. Australian Family Physician. 38(3), 85-88.  Retrieved May 5, 2011, from ProQuest Medical Library. Read More