Suicide and Substance Abuse in Adolescents

Suicide is the second or third leading cause of death among adolescents in the industrialized world. Adolescent suicidal behaviors pose a major global public health concern since they are highly prevalent and associated with heavy mortality and morbidity. A plethora of accumulated data substantiate the connection between suicide and substance abuse in adolescents and pose substance use disorders as a major risk factor for emergent suicidal behaviors. This chapter reviews recent patterns and trends of substance abuse, focusing mainly on alcohol and cannabis, which are most prevalent among adolescents, and presents the existing evidence linking adolescent suicidal behavior and substance abuse. We address the role of salient moderating factors such as comorbid psychiatric pathologies, age, and gender differences on this relationship and highlight vulnerable subpopulations such as sexual minorities that are predisposed to be affected by this connection. Perspectives on recent as well as future basic science research studying the connection between adolescent suicide and substance use as well as substance use trends are discussed. Treatment strategies for substance use disorders as well as for suicidal behaviors are presented, arguing in favor of an integrated approach.