There are many risks and dangers associated with substance abuse: brain damage, addiction, cancer and others. What most people don\u2019t consider when they first start using is that they are putting themselves at risk for death by suicide. It is the hidden risk of substance abuse and it is a terrifying thought. If you knew that you might end your own life, would you have tried using drugs in the first place? When more people understand this serious risk, hopefully more will make a smart choice to never use drugs. Facts About Suicide and Substance Abuse One of the most dominant risk factors for suicide is substance abuse. Drugs of abuse are often used as the method of suicide. Poisoning is the third-most common suicidal method. Seventy five percent of these suicides by poisoning involved a drug or alcohol, as opposed to some other substance such as carbon monoxide. Many of these poisoning suicides included both a drug and alcohol. Prescriptions are the most common drugs used in suicide attempts. Statistics involving drugs and suicide may be even more alarming than the facts currently demonstrate. When someone overdoses on a drug, it can be difficult to determine whether it was accidental or intentional. Unless the victim left a note or spoke to someone about her intentions, the assumption is usually accidental. This means that many deaths ruled accidents may have been suicides. A Complicated Relationship We know based on the facts that suicide and substance abuse are linked. What we don\u2019t know for sure is exactly why this relationship exists. There are many ideas, but the research is limited and making definite conclusions is difficult. Substance abuse is a strong risk factor for suicide. It comes second only to having a mood disorder, like depression. Understanding why substance abuse could be a risk factor for depression doesn\u2019t require a big leap of the imagination. Drugs are mind-altering substances. They can make you think and feel things you wouldn\u2019t otherwise. Becoming addicted can cause you to lose a number of important things and people in your life. This can lead to depression and feelings of hopelessness that might then lead to suicide attempts. It may be this loss of hope, a feeling of having no other options and of having lost everything that is at the root of most substance abuse-based suicides. Another consideration is the connection between substance abuse and mental health. Drug and alcohol use can trigger symptoms of mental illness including depression, anxiety and bipolar disorders. These are the biggest risk factors for suicide, so substance abuse may lead to suicide in a roundabout manner. Also, people with existing but untreated mental health disorders may use substances to self-medicate. The combination of using drugs and avoiding treatment could exacerbate the condition and further lead to suicidal thoughts. While both substance abuse and mental health carry stigma, suicide may be the bigger taboo. This could explain why we don\u2019t often hear about it in connection with drugs and alcohol. It is time to stop ignoring this issue and recognize that people abusing substances face a very serious and real risk of dying by suicide. Prevention, education and awareness would all go a long way toward preventing such deaths. Diagnosis and treatment of substance abuse disorders and mental illnesses are also needed to help those at risk for suicide.