The role of alcohol in suicide

A Portland State professor found new data on the presence of alcohol among suicide decedents, which points to a higher presence of alcohol among American Indians and Alaskan natives. “In general, the AI/AN group showed the highest prevalence of alcohol,” said Dr. Mark Kaplan, the study’s principal investigator.

A Portland State professor found new data on the presence of alcohol among suicide decedents, which points to a higher presence of alcohol among American Indians and Alaskan natives.

“In general, the AI/AN group showed the highest prevalence of alcohol,” said Dr. Mark Kaplan, the study’s principal investigator.

Kaplan and a team of specialists set out to look at the general role of alcohol in suicidal behavior at the start of the study, which spanned three years.

The team examined the blood alcohol content of every death by suicide from 2003–09 in 16 U.S. states, for a total of 59,384 suicide decedents, male and female.

With acute alcohol intoxication defined as a BAC greater than or equal to 0.08 grams/deciliter, the levels of suicide decedents who tested with a positive BAC varied greatly among ethnic groups.

The AI/AN group tested highest, with 47 percent of suicide decedents testing positive for acute alcohol, while Hispanics followed at 38 percent, whites at 33 percent, blacks at 26 percent and Asians/Pacific Islanders at 23 percent.

“Also a bit of a surprise was the levels of intoxication,” Kaplan said.

Those who tested positive within the AI/AN group had the highest mean BAC level at two to three times the legal intoxication level, Kaplan said.

“However, it is important to note that the AI/AN group does not encompass all tribes. Not all are equally at risk and it is important to not lump these different groups together,” he added.

Kaplan and his team also tried to get the best sense of the role that alcohol played in the act of suicide.

“We found two basic types of alcohol users. The first type is the person with a chronic alcohol disorder, and the second is the person who may have turned to alcohol for a more immediate role,” Kaplan explained, also noting that alcohol reduces inhibitions and can be known as “liquid courage.”

With suicide as the 10th leading overall cause of death in the U.S. as of 2009, Kaplan feels it is important to take a better look at prevention strategies.

Other sections of the study focused on different variables in alcohol’s role in suicidal behavior. Kaplan and his team looked at how alcohol might affect the means of death, as well as if there were any gender differences among suicide decedents.

“Alcohol does play a big role in gun violence,” Kaplan said. “Firearm suicides are high in the AI/AN group, and two-thirds of all gun deaths are suicide.”

Kaplan believes that a combination of alcohol availability, gun access and untreated mental-health issues are the cause of many suicides.

“It’s been proven that the more alcohol available, the more social problems,” he said.

While Kaplan feels that limiting access to alcohol could greatly decrease the number of suicides, especially among those in the AI/AN group, Rachel Cushman, a specialist from the PSU Native American Student and Community Center, disagrees.

“I don’t think [limiting alcohol availability] would do much—many ‘dry’ reservations still have high alcoholic rates,” she said.

While Cushman was unfamiliar with the exact numbers relating to alcohol use in AI/AN suicides, she noted that she was not surprised to hear that they tested positive the most frequently.

“It is commonly known that Native Americans have some of the highest alcoholic rates, but it is often overlooked that they also have some of the highest recovery rates,” she said.

Rather than addressing alcohol availability, Cushman believes that there is a great amount of healing that needs to be acknowledged and taken care of.

“With only 2 percent of the Native American population left, there is a great historical trauma to be dealt with stemming from years of removal and boarding schools,” she said.

“Most tribes have the same, if not less, access to alcohol, and so I believe it is the healing that first needs to be addressed,” she added.

Cushman suggested increasing education about ways to cope and heal, as well as a greater focus on the positives of Native American culture rather than the negatives.

Problems that Kaplan and his team had to face during the study included “a general lack of uniformity in quality and quantity in death investigation reports,” he said.

By increasing the standard of quality for such reports, Kaplan believes that more accurate information could be used in continuous suicide prevention efforts.

Kaplan said his team members worked extremely well together and that they “were able to get things done together that would have been impossible to get done separately,” he said.

“It’s great when you can have faculty who are engaged in research and they can bring it into the classroom,” Dr. Carlos Crespo said of Kaplan. Crespo is a PSU professor and the director of the College of Community Health.

“Textbooks are outdated before they are even published, so for students to learn about updated and relevant research in the classroom better prepares them to go out and work,” Crespo said.

The study will be published in May.