Does Sex and Drug Use Increase Teen Suicide Risk?

Depressed teen sitting on stairs

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Information presented in this article may be triggering to some people. If your child is having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

According to the Centers for Disease Control and Prevention (CDC), suicide is the second leading cause of death for teens in the United States. Plus, the rates of depression and suicide among U.S. teenagers have been increasing for decades. Although many factors are involved in this increase, several studies suggest an association between suicide and high-risk behaviors like sex and drug use.

A Closer Look at the Research

When it comes to high-risk behaviors, one study found that teens who engage in things like drinking, smoking, or sexual activity were more vulnerable to depression, suicidal thoughts, and suicide attempts. The study also found that the odds ratios were highest among teens who engaged in drug use.

However, it's important to note that a direct cause and effect has not been established. Instead, risky behaviors and suicide are more likely to occur together. For instance, researchers of a more recent study of Korean teens found that although 35% of teen drug users attempted suicide, these teens were also more likely to have existing mental health issues.

These findings suggest that drug use and mental health issues, including the risk for suicide, may occur together.

Likewise, the researchers found that depression and use of multiple drugs were independent risk factors. And, while they noted that violence victimization and excessive alcohol use were also associated with suicide attempts, these were no longer significant contributing factors after adjustment for other variables.

Meanwhile, a meta-analysis of 43 different studies with nearly 900,000 participants noted that there is a strong connection between substance abuse disorders and suicidal ideation, attempts, and even death. Based on the evidence they reviewed, they concluded that illicit drug use of any type should be considered an important risk factor for suicide.

While there’s little doubt these factors can contribute to poor mental health for teens, the relationship between all of these factors is complex. Researchers in all the studies maintain that teens who are engaged in risky behaviors like drug use, sexual activity, vaping, and binge drinking also should be screened for suicidal ideation.

For instance, when treating and preventing drug use, it would be wise to also ask about suicidal thoughts and plans. Teens may need help in dealing with both issues as they progress through recovery.

Whether or not these factors and behaviors cause suicidal ideation in teens, it's important to know that they're certainly associated with it. What's more, if you see any of these activities in your teen's life, it's important to be vigilant.

Teen Sex and Depression

Simply engaging in sexual behaviors doesn't automatically mean a teen will become depressed or commit suicide—the type of relationship and its context may make a difference. For instance, in 2018, a team of researchers at Cornell found that teens who engage in casual, non-romantic sex, or “hookups,” may be more prone to developing depression than their sexually-active peers who are in stable relationships. 

Likewise, another study found the age in which sex is initiated also is a contributing factor for depression, especially among girls.

For instance, the researchers assessed more than 4,000 teens and found that female teens who had sex before they were 17 years old were more likely to experience depression. Meanwhile, other studies have indicated that sexually-active teens who participate in “sexting” may be more likely to have mental health problems as well as be more likely to be delinquent.

It's important to note that sexually-motivated behaviors and activities may influence mental health for teens. For this reason, parents need to be aware of the risks associated with sexual activity at a young age and take time to talk to their kids about sex and consent.

Substance Use and Depression

Research from 2018 indicates that teens are using drugs and alcohol at lower rates than in previous decades. Exceptions to these trends include marijuana use, which has rates that have remained steady and vaping, which has rates that have significantly increased.

What's more, teens are more likely to use marijuana every day rather than cigarettes. In fact, in response to an annual National Institutes of Health survey, fewer teens in school now disapprove of regular marijuana use. But what is the link between drug use and suicide?

According to one study, there is a causal connection between drug use and suicide. For instance, researchers discovered that substance abuse is related to more suicidal behavior in both girls and boys.

Additionally, they noted that substance use also may cause teens to struggle in their relationships with peers as well as fail to meet daily obligations like attending school or completing schoolwork—all of which increase the risk for suicide. The researchers also indicated that the effects of drug use may impair a teen's judgment, reduce inhibition, and decrease impulse control, which also may contribute to suicidal behavior.

Screening and Treatment

If your child is engaging in high-risk behaviors like sex or drug use, it's important that you also the consider that possibility that it can increase their risk for suicide. So be sure you are aware of the signs of suicide and work closely with your teen's doctors and counselors.

Additionally, it's important to note the differences between causes and risk factors. When it comes to teen drug use and sexual activity, these two behaviors increase a teen's risk for suicide, but they do not necessarily cause it. Still, the connection is important and should be considered.

The US Preventive Services Task Force recommends that all adolescents and teens be screened for depression. And it's especially important to screen teens for depression if they report having sex and/or using drugs. Likewise, any teen who reports engaging in these behaviors, especially if their use is more than just dabbling, should also be screened for suicidal ideation.

If you know your teen is engaging in these behaviors, ask your child's doctor to screen them for depression and suicide risk.

Likewise, keep talking to your teens about the risks associated with sexual activity and drug use. In fact, studies have shown that harm reduction approaches are most effective especially when compared to abstinence-only sex education. Additionally, providing information about and access to contraceptives does not lead to increased sexual activity. 

The same is true regarding suicide. Talking about it with your teen doesn't give them ideas or increase the likelihood that they will take their life. Instead, it shows that you are someone they can talk to and be honest about their feelings.

A Word From Verywell

For teens, emerging sexuality, peer pressure, and exposure to drugs and alcohol can cause stress in their lives. For this reason, it's important that you understand how these behaviors can sometimes co-exist with depression and even suicide. This understanding includes being able to use these facts to talk with your teen freely about these topics and without shame.

Preteens and teens also need access to accurate and actionable information as well as resources to help them become more informed about their sexual health, drug use, and mental health issues. Consequently, it's a good idea to help them recognize the signs of suicide risk, substance abuse, and depression and point them toward resources available at school or within your community.

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