Abstract
Objectives: To review the association between substance abuse and risk of suicide and self-harm.
Methods: Based on a review of the relevant literature, a consideration is made of the relevance of psychiatric diagnosis, personality, and the role of substance-induced disinhibition in the production of self-harming behaviour in these populations. The relative importance of biological and social-cultural factors and the importance of substance abuse as a risk factor for self-harm are emphasized. Data is also presented from a study conducted by the author on a cohort of individuals admitted to a Sydney inpatient detox unit.
Results: The literature indicates the powerful relationship which exists between substance abuse and self-harm. This appears to be mediated largely by comorbid psychiatric illness and/or by impul-sivity, possibly exacerbated by the direct pharmacological effects of the substances. In the study cohort a high rate of self-harm history is noted, and this appears to be associated with clearly recognizable attributes including increased length of stay, a psychiatric diagnosis (Axes I and II), poor psychosocial circumstances, and female gender. It is recommended that risk of self-harm should be routinely considered in Drug and Alcohol treatment settings where it has not hitherto been a focus of attention.