Adolescent substance use and suicidal behavior: a review with implications for treatment research.
- Authors
- Esposito-Smythers, Christianne; Spirito, Anthony
- Year
- 2004
- Journal
- Alcoholism, clinical and experimental research
- PMID
- 15166639
- DOI
- 10.1097/01.alc.0000127417.99752.87
Adolescent substance use (alcohol and other drugs) and suicidal behavior, independently, pose serious public health problems. Youths who report co-occurring substance use and suicidality are a particularly high-risk group. In this review, we explore four areas that are pertinent to research with substance-abusing and suicidal adolescent populations. First, we review epidemiological research that is relevant to the association between substance use and suicidal behavior. Results suggest that substance use heightens statistical risk for suicidal behavior in adolescent clinical and community populations. Alcohol intoxication may serve as a proximal risk factor for suicidal behavior among distressed youths through its psychopharmacological effects on the brain. Substance use may also serve as a distal risk factor for suicidal behavior by increasing stress and exacerbating co-occurring psychopathology. Second, we propose different theoretical models that might explain the high rates of co-occurring substance use and suicidal behavior among adolescents. Substance use may stem from an underlying syndrome of problem behavior among impulsive suicide attempters with predominant externalizing symptoms. In contrast, nonimpulsive suicide attempters with predominant internalizing symptoms may use substances to cope with negative affective states. Third, we explore the status of treatment research with substance abusing and suicidal adolescent populations. Studies of substance abuse treatment and suicidal behavior have neither adequately assessed nor incorporated treatment of the other co-occurring problem. Finally, we conclude with proposed directions for future research, including the development of integrated interventions tailored to adolescents with these co-occurring problems.
No figures extracted from this document.
No chunks β full text not yet ingested.
No entities extracted from this document yet.
No uploaded files.
No citations found.
In this knowledge base
| Title | Year | PMID |
|---|---|---|
| Reciprocal relationships between substance use and disorders and suicidal ideation and suicide attempts in the Collaborative Study of the Genetics of Alcoholism. | 2017 | 28213124 |
External
| Title | Authors | Journal | Year | Link |
|---|---|---|---|---|
| Alcohol use, risk of suicide, and access to firearms among youth in Colorado. | Barnard LM et al. | β | 2026 | β |
| Addiction profile is associated with suicidal behavior and repetition of non-suicidal self injury: a latent profile analysis study in a schooled adolescents. | Arqueros M et al. | β | 2025 | β |
| Association of Suicide Risk Factors and Subsequent Pediatric Emergency Department Mental Health Visits. | Cafferty R et al. | β | 2025 | β |
| Can socioeconomic status moderate the effect of a conflictive family environment on brain structure and externalizing/internalizing behavior in children and adolescents? | Trejos-Castillo E et al. | β | 2025 | β |
| Inconsistent Reporting Affects the Link Between Substance Use and Suicide Attempt in Adolescents. | Brisson R | β | 2025 | β |
| Trends in lifetime controlled drug use and associated risk factors among Japanese Junior High School Students: Findings from Nationwide Surveys, 2016-2024. | Mizuno S et al. | β | 2025 | β |
| Youth experiencing homelessness at risk for suicide: psychosocial risk factors and service use patterns. | Chavez LJ et al. | β | 2025 | β |
| Adolescents Who Do Not Endorse Risk via the Patient Health Questionnaire Before Self-Harm or Suicide. | Flores JP et al. | β | 2024 | β |
| Components of Outpatient Child and Youth Concurrent Disorders Programs: A Critical Interpretive Synthesis: Composantes des programmes de troubles concomitants des enfants et des jeunes ambulatoires : une synthΓ¨se interprΓ©tative critique. | Rosic T et al. | β | 2024 | β |
| Protective behavioral strategies as a protective factor against suicidal ideation among college student drinkers. | De Leon AN et al. | β | 2024 | β |
| Social connectedness and adolescent suicide risk. | Arango A et al. | β | 2024 | β |
| Suicidal thoughts and behaviors among untreated illicit substance users: a population-based study. | Shiraly R et al. | β | 2024 | β |
| Suicidal Thoughts and Behaviors Among US Adolescents: The Cumulative Effects of Polysubstance Use Behaviors. | Yang Y | β | 2024 | β |
| Use of Tobacco Products and Suicide Attempts Among Elementary School-Aged Children. | Lee PH et al. | β | 2024 | β |
| Adolescents in Treatment for Substance Use Disorders: Callous-Unemotional Traits Moderate Associations Between Transdiagnostic Symptoms and Adolescent Suicidality. | Winters DE et al. | β | 2023 | β |
| Child maltreatment and youth suicide risk: A developmental conceptual model and implications for suicide prevention. | Duprey EB et al. | β | 2023 | β |
| Cross-sectional Study of Factors Associated With Suicide Ideation in Ontario Adolescents. | Rakoff J et al. | β | 2023 | β |
| Heterogeneous trajectories of suicidal ideation among homeless youth: predictors and suicide-related outcomes. | Wu Q et al. | β | 2023 | β |
| How are young people's mental health related to their sexual health and substance use? A systematic review of UK literature. | Harmanci D et al. | β | 2023 | β |
| Preventing Youth Suicide: Potential "Crossover Effects" of Existing School-Based Programs. | Ayer L et al. | β | 2023 | β |
| Suicide in young people: screening, risk assessment, and intervention. | Hughes JL et al. | β | 2023 | β |
| Beliefs about causal factors for suicide in rural Alaska Native communities and recommendations for prevention. | Skewes MC et al. | β | 2022 | β |
| Comparative effectiveness of individual versus family-based substance use treatment on adolescent self-injurious thoughts and behaviors. | Ayer L et al. | β | 2022 | β |
| Differential Predictors of Suicidal Ideation and Suicide Attempts: Internalizing Disorders and Substance Use in a Clinical Sample of Adolescents. | Berny LM et al. | β | 2022 | β |
| Illicit Drug Use, Cognitive Distortions, and Suicidal Ideation Among Homeless Youth: Results From a Randomized Controlled Trial. | Wu Q et al. | β | 2022 | β |
| Long-term trends in adolescent alcohol, tobacco and cannabis use and emerging substance use issues in Aotearoa New Zealand. | Ball J et al. | β | 2022 | β |
| Advances in Research on Adolescent Suicide and a High Priority Agenda for Future Research. | Clayton MG et al. | β | 2021 | β |
| Feasibility of an Integrated Treatment Approach for Youth with Depression, Suicide Attempts, and Substance Use Problems. | Goldston DB et al. | β | 2021 | β |
| Gratitude and suicide risk among college students: Substantiating the protective benefits of being thankful. | Kaniuka AR et al. | β | 2021 | β |
| Preliminary analysis of low-level alcohol use and suicidality with children in the adolescent brain and cognitive development (ABCD) baseline cohort. | Aguinaldo LD et al. | β | 2021 | β |
| Trends and instigators among young adolescent suicide in the United States. | Labuhn M et al. | β | 2021 | β |
| Alcohol use and risk of suicide: a systematic review and Meta-analysis. | Amiri S et al. | β | 2020 | β |
| Associations Between Multiple Leisure Activities, Mental Health and Substance Use Among Adolescents in Denmark: A Nationwide Cross-Sectional Study. | Santini ZI et al. | β | 2020 | β |
| Cannabis use and stigma among Canadian high school students: Results from the 2015 and 2017 Cancer Risk Assessment in Youth Survey. | Buttazzoni A et al. | β | 2020 | β |
| Five Profiles of Adolescents at Elevated Risk for Suicide Attempts: Differences in Mental Health Service Use. | King CA et al. | β | 2020 | β |
| An mHealth approach to extend a brief intervention for adolescent alcohol use and suicidal behavior: Qualitative analyses of adolescent and parent feedback. | McManama O'Brien KH et al. | β | 2019 | β |
| Association between illegal use of substances and suicidal behavior in school students: An integrative review of empirical data. | Karanikola M et al. | β | 2019 | β |
| Longitudinal Reciprocal Associations Between Anxiety, Depression, and Alcohol Use in Adolescent Girls. | Schleider JL et al. | β | 2019 | β |
| Feasibility, acceptability, and preliminary effects of a brief alcohol intervention for suicidal adolescents in inpatient psychiatric treatment. | McManama O'Brien KH et al. | β | 2018 | β |
| Measuring Acquired Capability for Suicide within an Ideation-to-Action Framework. | Burke TA et al. | β | 2018 | β |
| Which healthy lifestyle factors are associated with a lower risk of suicidal ideation among adolescents faced with cyberbullying? | Rodelli M et al. | β | 2018 | β |
| Prevalence and correlates of suicidal ideation and attempts among children and adolescents. | Sampasa-Kanyinga H et al. | β | 2017 | β |
| Randomized pilot trial of a cognitive-behavioral alcohol, self-harm, and HIV prevention program for teens in mental health treatment. | Esposito-Smythers C et al. | β | 2017 | β |
| Reciprocal relationships between substance use and disorders and suicidal ideation and suicide attempts in the Collaborative Study of the Genetics of Alcoholism. | Agrawal A et al. | β | 2017 | β |
| Risk and Resilience Factors for Depression and Suicidal Ideation in Mongolian College Students. | Davaasambuu S et al. | β | 2017 | β |
| Sexual Trauma, the Dopamine D4 Receptor, and Suicidal Ideation Among Hospitalized Adolescents: A Preliminary Investigation. | Doorley J et al. | β | 2017 | β |
| Suicidal ideation and behavior in institutions of higher learning: A latent class analysis. | Bernanke J et al. | β | 2017 | β |
| Alcohol Consumption as a Risk Factor for Suicidal Behavior: A Systematic Review of Associations at the Individual and at the Population Level. | NorstrΓΆm T et al. | β | 2016 | β |
| Clinician Perspectives on Treating Adolescents with Co-occurring Post-Traumatic Stress Disorder, Substance Use, and Other Problems. | Adams ZW et al. | β | 2016 | β |
| Emergency Department Screening for Suicide and Mental Health Risk. | Babeva K et al. | β | 2016 | β |
| Evaluation and Management of Children and Adolescents With Acute Mental Health or Behavioral Problems. Part I: Common Clinical Challenges of Patients With Mental Health and/or Behavioral Emergencies. | Chun TH et al. | β | 2016 | β |
| Executive Summary: Evaluation and Management of Children and Adolescents With Acute Mental Health or Behavioral Problems. Part I: Common Clinical Challenges of Patients With Mental Health and/or Behavioral Emergencies. | Chun TH et al. | β | 2016 | β |
| Prevalence and correlates of alcohol use among adolescents attending school in Kerala, India. | Jaisoorya TS et al. | β | 2016 | β |
| The contribution of the socio-demographic characteristics on suicidal ideation among Israeli soldiers. | Shelef L et al. | β | 2016 | β |
| The Effect of Race/Ethnicity on the Relation between Substance Use Disorder Diagnosis and Substance Use Treatment Receipt among Male Serious Adolescent Offenders. | Mansion AD et al. | β | 2016 | β |
| Two Studies of Connectedness to Parents and Suicidal Thoughts and Behavior in Children and Adolescents. | Conner KR et al. | β | 2016 | β |
| Evidence-based psychosocial treatments for self-injurious thoughts and behaviors in youth. | Glenn CR et al. | β | 2015 | β |
| Rethinking Adolescent Inpatient Psychiatric Care: The Importance of Integrated Interventions for Suicidal Youth With Substance Use Problems. | McManama O'Brien KH | β | 2015 | β |
| Suicidality among adolescents engaging in nonsuicidal self-injury (NSSI) and firesetting: the role of psychosocial characteristics and reasons for living. | Tanner AK et al. | β | 2015 | β |
| Universality properties of school-based preventive intervention targeted at cannabis use. | MiovskΓ½ M et al. | β | 2015 | β |
| Differentiating adolescent suicide attempters from ideators: examining the interaction between depression severity and alcohol use. | McManama O'Brien KH et al. | β | 2014 | β |
| Evaluating a brief, internet-based intervention for co-occurring depression and problematic alcohol use in young people: protocol for a randomized controlled trial. | Deady M et al. | β | 2014 | β |
| Heavy episodic drinking and deliberate self-harm in young people: a longitudinal cohort study. | Rossow I et al. | β | 2014 | β |
| Hopelessness, individualism, collectivism, and substance use among young rural-to-urban migrants in China. | Du H et al. | β | 2014 | β |
| Suicidal thoughts and attempts among u.s. High school students: trends and associated health-risk behaviors, 1991-2011. | Lowry R et al. | β | 2014 | β |
| Effects of the minimum legal drinking age on alcohol-related health service use in hospital settings in Ontario: a regression-discontinuity approach. | Callaghan RC et al. | β | 2013 | β |
| How Do Cognitive Distortions and Substance Related Problems Affect the Relationship Between Child Maltreatment and Adolescent Suicidal Ideation? | Miller AB et al. | β | 2013 | β |
| Impacts of the minimum legal drinking age legislation on in-patient morbidity in Canada, 1997-2007: a regression-discontinuity approach. | Callaghan RC et al. | β | 2013 | β |
| Pediatric mental health emergencies and special health care needs. | Chun TH et al. | β | 2013 | β |
| Not only body weight perception but also body mass index is relevant to suicidal ideation and self-harming behavior in Japanese adolescents. | Kinoshita K et al. | β | 2012 | β |
| Substance abuse and suicide risk among adolescents. | Pompili M et al. | β | 2012 | β |
| Substance abuse and suicide risk among adolescents. | β | β | 2012 | β |
| Working With the Suicidal Client Who Also Abuses Substances. | Esposito-Smythers C et al. | β | 2012 | β |
| Cognitive-behavioral therapy for adolescent depression and suicidality. | Spirito A et al. | β | 2011 | β |
| Examining gender differences in risk factors for suicide attempts made 1 and 7 years later in a nationally representative sample. | Thompson MP et al. | β | 2011 | β |
| Kava drinking associated with suicidal behaviour among young Kanaks using kava in New Caledonia. | Vignier N et al. | β | 2011 | β |
| The role of child sexual abuse in the etiology of suicide and non-suicidal self-injury. | Maniglio R | β | 2011 | β |
| Treatment of co-occurring substance abuse and suicidality among adolescents: a randomized trial. | Esposito-Smythers C et al. | β | 2011 | β |
| Assessing and treating co-occurring disorders in adolescents: examining typical practice of community-based mental health and substance use treatment providers. | Lichtenstein DP et al. | β | 2010 | β |
| Associations of the DRD2 TaqIA polymorphism with impulsivity and substance use: preliminary results from a clinical sample of adolescents. | Esposito-Smythers C et al. | β | 2009 | β |
| Cannabis use and deliberate self-harm in adolescence: a comparative analysis of associations in England and Norway. | Rossow I et al. | β | 2009 | β |
| Drinking alcohol before age 13 and negative outcomes in late adolescence. | Peleg-Oren N et al. | β | 2009 | β |
| Substance use and the treatment of resistant depression in adolescents. | Goldstein BI et al. | β | 2009 | β |
| A prospective investigation of suicide ideation, attempts, and use of mental health service among adolescents in substance abuse treatment. | Ramchand R et al. | β | 2008 | β |
| A Test of Problem Behavior and Self-Medication Theories in Incarcerated Adolescent Males. | Esposito-Smythers C et al. | β | 2008 | β |
| Attempted suicide and associated risk factors among youth in urban Japan. | Hidaka Y et al. | β | 2008 | β |
| Challenges and opportunities in the treatment of adolescents with substance use disorder and suicidal behavior. | Esposito-Smythers C et al. | β | 2008 | β |
| Depression, desperation, and suicidal ideation in college students: results from the American Foundation for Suicide Prevention College Screening Project at Emory University. | Garlow SJ et al. | β | 2008 | β |
| Substance use disorders among adolescents with bipolar spectrum disorders. | Goldstein BI et al. | β | 2008 | β |
| Suicide attempt and sexual risk behavior: relationship among adolescents. | Houck CD et al. | β | 2008 | β |
| A 10-year retrospective study of inpatient adolescents with schizophrenia/schizoaffective disorder and substance use. | Shoval G et al. | β | 2007 | β |
| Cocaine and alcohol use preceding suicide in African American and white adolescents. | Garlow SJ et al. | β | 2007 | β |
| The role of the pediatrician in preventing suicide in adolescents with alcohol use disorders. | Carballo JJ et al. | β | 2007 | β |
| Adaptive functioning, psychopathology and service use among 18-year-old boys with drunkenness-related alcohol use. | NiemelΓ€ SM et al. | β | 2006 | β |
| Attempted and completed suicide in adolescence. | Spirito A et al. | β | 2006 | β |
| Gender differences in associations between depressive symptoms and patterns of substance use and risky sexual behavior among a nationally representative sample of U.S. adolescents. | Waller MW et al. | β | 2006 | β |
| Impulsive-aggressive traits and suicidal adolescents and young adults with alcoholism. | Carballo JJ et al. | β | 2006 | β |
| Problems and costs associated with alcohol and drug abuse in emergency medicine. | Huber FX et al. | β | 2006 | β |
| Psychiatry in orthodontics. Part 2: Substance abuse among adolescents and its relevance to orthodontic practice. | Neeley WW et al. | β | 2006 | β |
| Psychotherapy in the treatment of alcohol and substance abusing adolescents with suicidal behavior. | Conason AH et al. | β | 2006 | β |
| Substance use, suicidality, and adolescent-onset schizophrenia: an Israeli 10-year retrospective study. | Shoval G et al. | β | 2006 | β |
| Suicidal ideation among adolescents with alcohol use disorders during treatment and aftercare. | Kaminer Y et al. | β | 2006 | β |
| The role of child and adolescent mental health services in suicide prevention in New Zealand. | Fortune S et al. | β | 2006 | β |
| The use of illicit substances in adolescent schizophrenia inpatients. | Shoval G et al. | β | 2006 | β |
| Alcohol and adolescent suicide. | Sher L et al. | β | 2005 | β |
| Completed suicides in a youth centres population. | Renaud J et al. | β | 2005 | β |
| How many pins? A case report of a girl who swallowed more than 50 straight pins in a suicide attempt. | Bloch Y et al. | β | 2005 | β |