Suicides Due to Alcohol 

and/or Drug Overdose

A Data Brief from the National 

Violent Death Reporting System

National Center for Injury Prevention and Control 

Division of Violence Prevention
Background

Suicide occurs when a person ends his or her own 

life. It is the 11th leading cause of death among 

Americans, and every year more than 33,000 

people end their own lives. Suicide is found in 

every age, racial, and ethnic group to differing 

degrees (1). 

There are a number of factors that increase the 

likelihood a person will take his or her own life; 

one of these is abusing substances such as alcohol 

and drugs (1). Alcohol and drug abuse are second 

only to depression and other mood disorders as 

the most frequent risk factors for suicidal behavior 

(2, 3). Alcohol and some drugs can result in a loss 

of inhibition, may increase impulsive behavior, 

can lead to changes in the brain that result in 

depression over time, and can be disruptive to 

relationships—resulting in alienation and a loss 

of social connection (4). Furthermore, excessive 

acute drug and/or alcohol ingestion could result in 

death. According to data from a recent National 

Violent Death Reporting System (NVDRS) report, 

in 2007 alcohol was a factor in approximately onethird of the reported suicides, and 62% of these 

decedents had a Blood Alcohol Content (BAC) of 

>0.08 g/dL at the time of death (5). 

This data brief summarizes suicide deaths reported 

in the NVDRS due to poisoning by alcohol and/

or other drugs (illicit, prescription, and over-thecounter) ingestion as indicated by the cause of 

death on the death certificate. The brief contains 

data from 16 states implementing NVDRS from 

2005-2007. 

NVDRS is a state-based system for 

providing detailed information about 

violent deaths, such as when, where, 

and how they happen and other possible 

contributing factors. This information 

can be used to monitor homicides and 

suicides and design and evaluate prevention 

strategies.  Benefits of NVDRS include the 

following:

•	 Linked records describing the detailed 

circumstances that may contribute to a 

violent death

•	 Identification of violent deaths occurring 

together to help describe the circumstance 

of multiple homicides or homicidesuicides

•	 Timely preliminary information on 

violent deaths

•	 Better characterization of the relationship 

of the victim to the suspect

In NVDRS, suicide is defined as a death 

resulting from the use of force against oneself 

when the evidence indicates that the death 

was intentional (5). Unintentional poisonings 

or deaths caused by chronic or acute 

substance abuse without the intent to die are 

not classified as suicides and are not included 

in this report.

2
Results

From 2005-2007, there were a total of 26,902 

suicides in NVDRS-funded states. Poisoning was 

the third-leading method of suicide, following 

firearm and hanging/strangulation. Seventy-five 

percent (n=3,706) of suicides by poisoning were 

due to alcohol and/or drug overdose versus other 

types of poison such as carbon monoxide. Less 

than half (47%) of those who died by alcohol and/

or drug overdose were known to have an alcohol or 

substance abuse problem. 

Poisoning is a leading method in suicide 

deaths, and drugs and/or alcohol make up 

75% of suicide deaths due to poisoning. 

Substances Used in Suicides

•	 Sixty-nine percent of individuals who died 

by suicide due to substance overdose had 

ingested one type of drug (n=2,732); 25 

percent ingested two or more types of drugs 

(n=974) (Figure 1).

In suicides resulting from more than one 

substance, about one-third occur due to a 

combination of alcohol and prescription 

drugs. Almost another third are due to a 

combination of over-the-counter drugs and 

prescription drugs. 

Figure 1. Number of Suicide Deaths by Number of 

Drug Type—16 U.S. States, 2005-2007

0

500

1,000

1,500

2,000

2,500

3,000

Unknown/Not 

Reported

More Than One 

Drug Type

One Drug 

Type Only

Number of Suicides

3
4

Of those who consumed a single drug type:

•	 Prescription drugs such as those in the 

opioid, benzodiazepine, and antidepressant 

class (e.g.- oxycodone, diazepam, and 

fluoxetine) were the leading type used in 

suicide deaths. From 2005 to 2007, 79% of 

suicides due to substance overdose were due 

to prescription drugs only (n=2165).

•	 Over-the-counter drugs such as 

acetaminophen were the second leading 

substance type used in suicides. They 

represented 10% of suicides due to substance 

overdose (n=279).

•	 Street/recreational drugs and alcohol made up 

the smallest proportion of these suicides (2% 

and less than 1% respectively) (Figure 2).

The vast majority (79%) of substance 

overdose suicides are related to prescription 

drugs. The second most common 

substance used is acetaminophen.

Of those who consumed more than one type 

of drug:

•	 Alcohol and prescription drugs were ingested 

in 31% of suicides due to multiple substance 

overdose (n=298).

•	 Prescription drugs and over-the-counter drugs 

were ingested in 30% of cases (n=294). 

•	 Other (unspecified) combinations of 

substances were ingested in 24% of cases 

(n=236).

•	 Street/recreational drugs and prescription 

drugs were ingested in 12% of cases (n=119).

•	 Alcohol, street/recreational drugs, and 

prescription drugs were ingested in 2% of 

cases (n=22).

•	 Alcohol and street recreational drugs were 

ingested in < 1% of cases (n=5) (Figure 3).

Figure 2. Major Drug Types in Suicide Deaths Due to Single 

Substance Overdose—16 U.S. States 2005-2007 (n=2732)

Alcohol

Other specified substance

Unknown drug

Street Recreational

Over the counter (OTC)

Prescription drugs

79%

6%

10%

2%

2% 1%
5

Distribution by Demographic Group 

•	 Females die in disproportionate numbers 

from suicide due to alcohol and/or drug 

overdose. From 2005-2007, 34% of female 

suicides were due to alcohol and/or drug 

overdose, versus 8% of males (Table 1).

•	 15% of suicides among white non-Hispanics 

were due to alcohol and/or drug overdose; 

this equals almost two times the percentage 

of black non-Hispanics in the same category 

(8%) (Table 1).

•	 18% of suicide decedents between ages 

40 and 64 died from alcohol and/or drug 

overdose; this equals more than four times 

the percentage of those aged 17 years and 

younger in the same category (Table 1).

•	 The percent of total suicides due to alcohol 

and/or drugs in NVDRS-funded states range 

from 5.8% to 19.8% (Table 2).

Figure 3. Major Drug Types in Suicide Deaths Due to Multiple 

Substance Overdose—16 U.S. States 2005-2007 (n=974)

Alcohol & Street/

Recreational Drugs

Alcohol, Street/Recreational

& Prescription Drugs

Street/Recreational & 

Prescription Drugs

Other Combination 

of Substances

Prescription & Over the 

Counter (OTC) drugs

Alcohol and Prescription 

Drugs

31%

30%

24%

12%

2% 1%
6

Table 1. Number and percent of suicides due to drug and/or alcohol ingestion, by 

decedent sex, race/ethnicity, and age group, 16 NVDRS states, 2005-2007

Characteristic No.

% of Total Suicides Due to 

Poisoning by Drugs/Alcohol 

Sex

Male 1698 8

Female 2008 34

Race/Ethnicity

Hispanic 131 10

White, non-Hispanic 3322 15

Black, non-Hispanic 138 8

American Indian/Alaska Native, non-Hispanic 50 10

Asian/Pacific Islander, non-Hispanic 45 11

Unknown/Other 20 10

Age Group (years)

<17 31 4

18-39 1079 11

40-64 2313 18

>65 282 7

Unknown 1 10

Table 2. Number and percent of suicides due to drug and/or alcohol ingestion, by 

state, 2005-2007

State No.

% of Total Suicides in State Due to 

Poisoning by Drugs/Alcohol

Alaska 25 6

Colorado 368 17

Georgia 205 7

Kentucky 125 7

Maryland 179 13

Massachusetts 280 20

New Jersey 304 17

New Mexico 118 11

North Carolina 490 15

Oklahoma 231 15

Oregon 275 16

Rhode Island 42 17

South Carolina 173 11

Utah 170 16

Virginia 407 16

Wisconsin 314 16

TOTAL 3706 14
7

Implications & Recommendations

Drug and alcohol overdose account for a 

substantial number of suicides, and many of these 

deaths can be prevented by limiting access to 

substances. If lethal substances are not available 

when people are under psychological or emotional 

stress and despair, the ability to commit suicide 

is limited (6). Many of the substances used in 

suicides are either easily available, as in the case of 

over-the-counter drugs such as acetaminophen, or, 

like opioids, antidepressants, and benzodiazepines, 

are commonly prescribed to treat various 

physical and mental health conditions. Effective 

mental health treatment, which often includes 

pharmacologic therapy, is important to prevent 

suicide, however to adequately promote the safety 

and well-being of individuals at risk of suicide, 

consumers, family members, and others should 

be aware of the associated risk these substances 

pose. There are actions that state and local 

communities, policy-makers, and family members 

can take to reduce the number of suicides due to 

substance overdose.

Develop guidelines for safer prescribing and 

dispensing of medications. The National Strategy 

for Suicide Prevention calls for the development 

of guidelines for safer dispensing of medications 

for individuals at heightened risk of suicide. 

Policymakers should initiate strategies shown to 

be effective in preventing suicide. These include 

requiring bubble/blister packaging of analgesic pills 

instead of bottle packaging; limiting the number 

of pills pharmaceutical and nonpharmaceutical 

outlets can sell at one time, and providing printed 

warnings about the dangers of overdose with each 

sale of analgesics (7). Physicians and other clinicians 

should be educated about safe prescribing practices 

for suicidal individuals. Related efforts to address 

unintentional poisoning may also address suicide (8). 

For example, many states are developing statewide 

electronic databases to collect information on 

substances dispensed. This effort can provide valuable 

information on substance use and abuse trends that 

can affect drug policy and overdose prevention.

Teach families of suicidal individuals the 

importance of limiting access to substances 

in the home. Educational and skill-building 

interventions shown to be effective in reducing 

access to lethal substances should be implemented 

broadly in high-risk populations (9). Examples 

include educating parents and other family 

members in emergency departments, hospitals, 

and other clinical settings. Families should be 

educated on strategies to limit access at home to 

prescription drugs, over-the- counter analgesics, 

and alcohol. They should be educated about the 

potential dangers of alcohol in suicidal individuals 

and its ability to amplify the harmful effects of 

medications and other substances that can result in 

severe respiratory depression and death. 

Promote connectedness between health, mental 

health, and substance abuse providers and 

other community-based support organizations 

to build a safety net for suicidal individuals.

Increasing linkages between primary care, mental 

health, and substance abuse service providers and 

other community-based support organizations 

may allow for better identification, assessment, 

management, and treatment of at-risk individuals. 

A “team approach” can help ensure that those likely 

to work with suicidal individuals know appropriate 

actions to take to see that needed services are 

actually delivered and appropriate standards of care, 

monitoring, and follow-up are provided. 

Build social support networks for persons 

who are suicidal. Individuals who have regular 

interactions with social support networks that 

may include family, friends, teachers and school 

administrators, and a faith community can be 

protected from many of the factors that increase 

suicide risk such as alcohol and drug abuse 

(10,11,12). Families, friends, spiritual leaders, 

and other advisors of suicidal individuals can be 

instrumental in preventing suicide by maintaining 

open channels of communication about feelings of 

despair. They can encourage suicidal individuals to 

seek professional help and support them in other 

actions to save their life. 
8

If you or someone you know is struggling with 

feelings of hopelessness and /or thinking about 

suicide, call the National Suicide Prevention 

Lifeline, 1-800-273-TALK, to speak with a trained 

counselor and be connected with helpful resources 

in your area. 

Recommendations to help states, 

communities, policy-makers, and family 

members reduce the number of suicides 

due to substance overdose include:

•	 Develop guidelines for safer prescribing 

and dispensing of medications.

•	 Teach families of suicidal individuals 

the importance of limiting access to 

substances in the home.

•	 Promote connectedness between health, 

mental health, and substance abuse 

providers and other community-based 

support organizations to build a safety net 

for suicidal individuals. 

•	 Build social support networks for persons 

who are suicidal.

References

1. Centers for Disease Control and Prevention. 

Understanding Suicide. http://www.cdc.gov/

ViolencePrevention/suicide/index.html (23 

July 2010, date last accessed).

2. Borges G, Walters EE, Kessler RC. 

Associations of substance use, abuse and 

dependence with subsequent suicidal behavior. 

Am J Epidemiol 2000;15;781-9.

3. Tondo L, Baldessarini RJ, Hennen J, et al. 

Suicide attempts in major affective disorder 

patients with comorbid substance use disorders. 

J Clin Psychiatry 1999;60 (Suppl 2):S63-9.

4. Institute of Medicine. Reducing suicide: 

a national imperative. Washington D.C.: 

National Academies of Science; 2002.

5. Karch DL, Dahleberg LL, Patel N. 

Surveillance for Violent Deaths-National 

Violent Death Reporting System, 16 States, 

2007. CDC Surveillance Summaries, May 14, 

2010, MMWR 2010:59 (No SS-4).

6. The National Strategy for Suicide Prevention: 

Goals and Objectives for Action. Washington 

D.C. 2001.

7. Suicide Prevention Resource Center: Best 

Practice Registry. Limits on Analgesic 

Packaging http://www.sprc.org/featured_

resources/bpr/ebpp_PDF/analgesic_limits.pdf 

(25 August 2010 date last accessed).

8. Centers for Disease Control and Prevention. 

CDC Issue Brief: Unintentional Drug 

Poisoning in the United States. http://www.

cdc.gov/homeandrecreationalsafety/poisoning/

brief.htm (23 July 2010, date last accessed).

9. Suicide Prevention Resource Center: Best 

Practice Registry. Emergency Department 

Means Restriction Education. http://www.

sprc.org/featured_resources/bpr/ebpp_PDF/

emer_dept.pdf (25 August 2010 date last 

accessed).

10. Centers for Disease Control and Prevention. 

Connectedness as a Strategic Direction for 

the Prevention of Suicidal Behavior. http://

www.cdc.gov/violenceprevention/pdf/Suicide_

Strategic_Direction_Full_Version-a.pdf (15

August 2010 date last accessed).

11. School Connectedness: Strategies for 

Increasing Protective Factors Among 

Youth. http://www.cdc.gov/HealthyYouth/

AdolescentHealth/connectedness.htm (25 

August 2010 date last accessed).

12. Gearing R.E., Lizardi D. Religion and Suicide. 

Journal of Relig Health 2009:48;332-341.