Research Snapshot: Prevention of alcohol-related suicide: a rapid review

What you need to know

According to the World Health Organization, alcohol use is a significant risk factor for suicide, which ranks among the leading causes of death worldwide. However, alcohol use is commonly overlooked in suicide prevention programs and policies by clinicians, researchers and policy-makers. This study examined all available evidence on interventions to prevent alcohol-related suicide.

In this study, researchers conducted a rapid review of the evidence on alcohol-related suicide prevention interventions at the policy, community and clinical levels.

What is this research about?

Alcohol has been found to be a direct contributing factor in suicide deaths through alcohol poisoning or overdose in combination with other drugs. Several reviews on alcohol use and suicidal behaviour that support the association between alcohol and suicide rates have been conducted. Even though an association between alcohol and suicide has been demonstrated in these studies, the connection is often missed in prevention programs and policies by clinicians, researchers and policy-makers.

What did the researchers do?

The researchers conducted a rapid review of the available evidence on alcohol-related suicide prevention interventions. They searched PubMed, Embase and Web of Science Core Collections databases for articles relating to alcohol, suicide, prevention and policies, published between 1990 and 2020. Researchers then selected and examined 69 articles for data extraction, and interventions were categorized as policy, community-based, or clinical.

Researchers included studies that matched the following criteria:

What did the researchers find?

Overall, the researchers extracted data from 69 articles and presented the results in three groups:

Policy interventions: 49 publications, including structural policy interventions, such as alcohol control campaigns, local restrictions, pricing and taxation, physical availability, and minimum legal drinking age.

These studies demonstrated that population-level alcohol policies are important in preventing suicide and other harms related to alcohol consumption.

Community-based interventions: seven publications, including interventions implemented at a group level or in the community, such as group counselling or education.

These studies examined alcohol use, but with limited focus; therefore, the researchers suggested that more research on community-based interventions and alcohol use is needed.

Clinical interventions: 13 publications, including interventions that involve one-to-one care, such as medication or individual counselling.

These studies reviewed interventions preventing alcohol-related suicide; however, they were often limited by small sample sizes.

Limitations of the research

The researchers note that their study had several limitations. The study only had one reviewer in each stage of the process and was not a formal systematic review. Additionally, the selected review time period did not include publications from more than 30 years ago.

Other limitations included: the exclusion of a risk of bias assessment, not stratifying study results by gender, and the challenge of classifying deaths by suicide as different countries and jurisdictions may have varying guidelines.

How can you use this research?

The researchers suggest that in order to prevent alcohol-related suicide, alcohol needs to be considered as a proximal and distal risk factor. Implementing interventions and programs at the national and local levels may prevent alcohol-related suicide. Furthermore, tracking alcohol and other drug use at the time of death by implementing drug and alcohol screening would be beneficial to governments, non-governmental organizations and researchers. When looking at the individual level interventions, one-on-one counselling may help target the interaction between alcohol use and suicide. Screening, brief intervention and referral interventions could be considered to detect high-risk alcohol use among those experiencing suicidality. Lastly, community and clinical interventions for suicidal populations may want to consider alcohol use education as a component of the intervention. Overall,  comprehensive suicide prevention strategies need to address the risk factor of alcohol use.

About the researchers

Norman Giesbrecht1,2, Elizabeth K. Farkouh3 , Hariesh Pavalaghanthan4, and Heather Orpana5

  1. Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Canada
  2. Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
  3. Mayo Clinic Alix School of Medicine, Rochester, Minnesota, United States of America
  4. College of Medicine and Health, College Cork, Cork, Ireland
  5. Public Health Agency of Canada, Ottawa, Canada

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