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A Controversial Thought?

September 15, 2010

In the Adverse Childhood Experience Study (ACES), a direct correlation was found between increasing attempts at suicide with increasing numbers of childhood traumas, or ACE’s. For example, having 4 ACE’s in your background gave you a 1,220% greater risk of attempting suicide in your life over having none. It is generally accepted that 1 our of every 200 attempts is successful. Fortunately, suicide ideation does not develop in all of the population with 4 or more ACE’s, or we would quite obviously have an epidemic of suicides.

So why do most of the population with 4 or more ACE’s fail to progress to attempting suicide? How many individuals entertain ideation of suicide? What mediates this response in a majority of trauma impacted adults in this population?

One answer may shock you. In an article in the American Medical Association,[i] research seemed to indicate that alcohol abuse or depressive disorders may actually reduce the number of suicide attempts.

“Although a temporal relationship between the onset of substance abuse or depressive disorders and lifetime suicide attempts in the ACE Study cohort is uncertain, our analysis of the potential mediating effects of these known risk factors provides evidence that for some persons, adverse childhood experiences play a role in the development of substance abuse or depression. In turn, these problems may partially mediate the relationship between these experiences and suicide attempts.”

If I read the conclusion correctly, it may be that for some individuals with multiple aces, the use or abuse of alcohol, illicit drugs and onset of depressive disorders may prevent them from attempting suicide.

One of our state’s initiatives in rural Alaska is to reduce or eliminate the use of alcohol. The Alaska Rural Justice and Law Enforcement Commission has studied the regulation of alcohol in rural Alaska extensively, and has recommended methods to reduce the importation of alcohol into dry communities, and interdict alcohol destined for dry communities. It appears that one of the results of such efforts may be an increase in the number of suicide attempts.

I have not conducted additional research into this thought. But I do feel that it needs further research. I certainly don’t believe that alcohol abuse should be tolerated. However, it its use mediates other potentially severe problems, then we need to have a plan for addressing the root cause of the alcohol abuse, and that is unresolved childhood and adult trauma.

[i] “Childhood Abuse, Household Dysfunction, and the Risk of Attempted Suicide Throughout the Life Span: Findings from the Adverse Childhood Experiences Study, Dube et al., JAMA,. December 26, 2001—Vol 286, No. 24.”

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