How to Respond to Suicide Hints, Threats, and Attempts

Just about anyone who hints of or threatens suicide is profoundly ill, even if the threat of suicide is primarily an attempt to gain attention (which does not have to be a negative thing in this context, since they clearly need assistance), to access treatment, or to avoid abandonment. People who have a psychiatric disorder known as borderline personality disorder, in which they experience real or imagined abandonment, are given to dramatic demonstrations of their emotional need which may include attempts of suicide.

A significant percentage of people who have this psychiatric condition actually do eventually commit suicide, so professional intervention — the difficulties associated with borderline personality disorder are not something a friend can fix — is required for threats of suicide and even hints of suicide even if they seem to be "drama."

Modern Pain Relievers Are Extremely Potent

One thing to take into account is that the simple reality of modern antidepressants and pain relievers is that they can be very potent. Someone who is trying to relieve pain by taking multiple pain prescriptions (Heath Ledger's alprazolam, diazepam, doxylamine, hydrocodone, oxycodone, and temazepam, for instance) runs a real risk of death from respiratory or cardiac arrest. And it is death from taking too many prescription medications that is more likely to be accidental. In these cases, the person wanted to feel better, not to end their life.

If a doctor prescribes it, the user reasons, the combination of drugs has to be OK. The problem occurs when people start seeing multiple doctors to get multiple prescriptions for multiple pain relievers. What a friend can do is to be just a little nosy, and to ask if there isn't a better way to get the relief from pain or anxiety that is needed other than taking more and more pills. Even if the person reacts in a hostile way, which is likely, you may get them to think.

Street Drugs Have Unpredictable Effects

Street drugs are a more difficult problem. The people who refine cocaine and heroin don't run quality standards in their labs. Sometimes a batch of a drug won't be "cut." It will be full strength. Medical examiners will see multiple cases of drug overdoses in just a few days and pass on the word to police departments, and chiefs of police may even put out the word that people are dying of drug overdoses so that the drug dealers hear it. Drug dealers may not be pharmacologically astute, but they do realize that uncut drugs cost them money and dead people don't buy their drugs. When a drug dealer watches the local evening news and sees multiple reports of drug overdoses, they check their supplies.

Drug Stories on the Evening News Are Sometimes There for a Reason

And if you have a friend who uses street drugs, you should keep up with the evening news, too. "I know my dealer" isn't a guarantee that a drug will be safe. Friends usually can't persuade friends to give up their drug habits. But friends can warn friends when bad drugs are on the street, and ask them to be careful, avoid being the friend who provides them alcohol, and make a point of being there when they are needed to call for emergency help.

The simple truth is that you cannot always prevent a friend's drug overdose — but you can try, and sometimes, you will succeed.