Mental Health
Trends in alcohol and other substance use preceding suicide death in the United States: age-specific temporal trends, 2016-2022 Katherine Keyes* Katherine Keyes Victoria Joseph Caroline Rutherford
Suicide death rates increased in the US over the past decade; identifying causes of these increases is critical to design intervention and prevention efforts. Concomitant to suicide deaths increases have been increases in alcohol and other substance use in the US population. Given that alcohol and other substance use are frequently proximal to suicide death, there is a potential role of population-level increases in use on suicide death. The present study analyzed time trends alcohol and other substance involved suicide death rates. We used data on 109,561 suicide deaths with toxicology and Blood Alcohol testing data from 32 states with consistent reporting for study years in the National Violent Death Registry, annually from 2016 through 2022. Alcohol involvement was determined by Blood Alcohol Concentration testing at the time of death, and substance involvement through toxicology. Population denominators drawn from the US census. For those deaths with alcohol and other substance testing data, Figure 1 shows the trend over time in alcohol-only, other-substance-only, alcohol-and-other-substance, and neither, by age and sex. Alcohol-only-associated suicide death remains high for young adult and middle-age adult men, with a death rate of approximately 4 per 100,000. There was no systematic trend over time in alcohol or substance involved suicide for any sex-age group, however, there was heterogeneity by state. Alcohol-associated suicide deaths rates significantly increased over the study period in Kansas; other-substance-associated suicide deaths increased in Arizona, Kansas, Massachusetts and Oregon; and alcohol-and-other-substance-associated suicide deaths increased in Colorado, and Oklahoma. Results underscore that alcohol use continues to be associated with high suicide rates among young and middle-aged men, and while trends over time are consistent nationally, certain states are evidencing increases which may call for targeted region-specific intervention.
