1997). This “relief/escape” mechanism may result in the co-occurrence of suicidal and substance use behaviors. For example, suicidal ideation is associated with high levels of stress, and the anxiolytic or euphoric effect of particular substances may reduce stress (Light et al. 2003) or increase urge or desire to use drugs (Robinson and Berridge, 2000; Koob and Le Moal, 2001; Schepis et al. 2008). Furthermore, the progression of adolescent substance abuse may act as an amplifying feedback loop, where the development of a substance use disorder results in reciprocal impairments in neurobehavioral constructs, such as impulse control, and neurobiological processes. When specific external stresses occur, the combined effect may be heightened risk of suicidal behavior and ongoing substance abuse.
