Suicide danger heightened by opioids, substance abuse: Expert

At one time, talking about suicide was a major taboo.

But a lot has changed over the years and now during Suicide Prevention Month, it's essential families and friends have heart-to-heart chats with those close to them who may be going through a rough time.

“We need to raise awareness of the public health crisis it poses,” Waypoint Centre for Mental Health Care staff psychiatrist Dr. Mara Smith.

Smith, who works in the Penetanguishene hospital's acute assessment program, says statistics indicate close to a dozen people die by suicide every day nationally with the figure in the 4,500 range on an annual basis.

“Suicide rates are approximately three times higher among men compared to women,” she says, noting it’s also the second leading cause of death among youth and young adults aged 15 to 34.

During Suicide Prevention Month, Smith says she hopes people will take the opportunity to further examine their close relationships to determine if a loved one or even a friendly acquaintance may need help.

Some have called it a "permanent solution to a temporary problem."

But however one assesses suicide and the high price those left behind pay, it’s important to talk about what’s become a growing problem, according to Smith.

“We need to make sure people understand that it’s OK to talk about suicide,” Smith says. “It’s always been an issue, but there is a bit more concern for it now.”

While Smith says Canadians should be thankful the country has relatively strict gun laws compared to their American cousins, thereby reducing the risk of suicide by gunshot, another smoking gun continues to pose a major danger.

Smith says alcohol and drugs with particular attention to opioids lower inhibitions leading to somebody killing themselves who might not do it in a clear state of mind.

The opioid epidemic has created to a new concern that people are using the drugs to either end or attempt to end their lives using the potent drug, according to Smith, who notes it’s similar way to go out as those who used alcohol or other drugs in the past.

"The opioid epidemic and associated risks of overdose — whether they be intentional, unintentional, or somewhere in the grey space in between, which I have heard described as the practice of 'using suicidally'."

She recommends having naxolene on hand since it provides a safe and effective antidote to an opioid overdose.

"This medication has saved many lives and can be obtained relatively easily by speaking to a community pharmacist," Smith adds.

As for alcohol use, Smith says that some might only attempt suicide when impaired by alcohol since it lowers one’s inhibitions and serves as a depressant, meaning that in a clear state of mind he or she would likely still be alive.

“Not all deaths by suicide are linked to substance abuse,” she says, noting health professionals are still noticing the lingering effects of COVID-19 on the collective mindset since it "created a lot of isolation and loneliness and closure of community resources.”

There also a range of psychiatric conditions that can lead to feelings of worthlessness and despair, according to Smith, who pointed out there are a range of pharmaceuticals and other treatment options that can help people cope.

As an example, Smith says that to determine if someone might be experiencing major depression, friends and family should look for symptoms like ongoing sadness, tearing up easily and social withdrawal.

And that's where friends and family need to step up and not be timid to ask some tough questions, according to Smith.

“You can ask, ‘how you’re feeling’,” she says, noting if the person responds that he or she would ‘rather not be here’ or ‘life isn’t worth living’ that it might be time to seek external help.

She says there are many clues to look for if you suspect someone is considering suicide.

“They might not also be enjoying things they previously enjoyed,” she says, noting a previous interest in sports and/or arts could have waned. “You can also look for changes in energy level and weight loss.”

There are also myriad resources available to those without a closed loved one or friend and most are available at one's fingertips.

• Canadian Mental Health Association's 24/7 crisis support line (705) 728-5044/(888) 893-8333
• Kids Help Phone (800) 668-6868 (call or text CONNECT)
• 24/7 Indigenous support line (855) 242-3310
• 988 (the 911 for mental health) - call or text
• Present to your family doctor or nurse practitioner (or, if you don't have either of these, try a walk-in clinic or urgent care centre). To get on the wait-list for a family doctor, visit Health Care Connect.
• In the event of an emergency or crisis, call 911 or go to the nearest hospital emergency room.