A JIGGER OF ALCOHOL, A DASH OF DEPRESSION, AND BITTERS: A SUICIDAL MIX *

An exploration of the interface between the problems of suicide and alcoholism produces a series of striking, if unfortunate, similarities. Both behaviors are often attempts to deal with intense intrapsychic pain, and their potentially selfdestructive components need little documentation. Although complete statistics are extraordinarily difficult to determine, it has been estimated that 25,000 people suicide annually, making this the eleventh leading cause of death in the United States. Most investigators would agree that completed suicides represent only one aspect of the problem, however, and that suicide “attemptors” outnumber the “completors” by a conservatively-estimated 10: 1 ratio, or a quarter of a million people annually. Contrary to our experiences with the general suicidal population, the alcoholic who makes an attempt is far more likely to succeed, and, in fact, we would estimate that the ratio of alcoholic attemptors to alcoholic completors is far less than 1 O : l ; perhaps even 5 : l . The similar self-destructive nature of both behaviors, one covert (drinking) and the other overt (suicide), prompted us to examine further the overlap between suicide and alcohol. We will first present a discussion of certain issues of clinical significance and then follow with an overview of the literature in this area.