The Roles of High-Risk Substance Use and Psychological Distress on Suicidal Ideation Among Young Adults In the United States In 2022.

Background and Purpose:

This study examines the relationship between combined alcohol and drug use and the likelihood of suicidal ideation—thoughts, plans, and attempts—among young adults (ages 18–25) in the United States. Existing suicidality research largely focuses on broader adult populations, often excludes recent data (e.g., 2022), and tends to analyze factors such as substance use and psychological distress in isolation. It rarely considers their intersection, particularly the combined effects of high-risk substance use and psychological distress on suicidality (Jones et al., 2023).
Methods:

The study investigates how this relationship is mediated by psychological distress and moderated by the risks associated with substance use. By utilizing data from the 2022 National Survey on Drug Use and Health, which includes an analytic sample of 45,189 young adults in the U.S. in 2022. The hypothesis is individuals who partake in alcohol and drug consumption are more prone to experiencing suicide ideation compared to their counterparts who abstain from such behaviors. The study accounts for potential confounding factors such as age, sexual orientation, employment status, and family income. I use logistic regression models to assess the association between consuming alcohol with drugs, related factors, and suicide ideation (ideas, planning, and attempts). I impute missing independent variables using MICE (White et al., 2011), including the dependent variable as recommended (von Hippel, 2007).The KHB approach to mediation further elucidates how levels of psychological distress partially explains the connection between high-risk substance use and suicidal ideation.

Results:

In 2022, suicide ideation is 1.21 higher on average for individuals who consume alcohol with drugs than individuals who do not; this relationship is statistically significant (p<0.000). Results indicate that psychological distress and high-risk substance use significantly mediate and moderate suicidal ideation, respectively. Specifically, the KHB results confirms that 29.64% of the relationship between alcohol and drug consumption is explained by psychological distress levels. The average log odds of suicidal ideation for individuals who consume alcohol with drugs and engage in high-risk substance use is 0.79. Individuals who consume alcohol with drugs and engage in high-risk substance use exhibit 2.20 times higher levels of suicidal ideation than those who do not engage in high-risk substance use.
Conclusions and Implications:

In 2022, individuals who consume alcohol along with drugs are more likely to experience suicidal ideation compared to those who do not. This relationship is particularly pronounced among young adults experiencing both higher levels of psychological distress and a high risk of substance use. Factors such as age, sexual orientation, family income, and employment status offer alternative explanations for the link between consuming alcohol with drugs and the likelihood of experiencing suicidal ideation among this population. Overall, these findings support the importance of screening for suicidality in individuals at high risk of substance use and experiencing high psychological distress to address both conditions. When developing suicide screening, assessment, prevention and intervention strategies, it is crucial to consider the differential effects of age, sexual orientation, family income, and employment status on the risk of suicidality.