# Determining the links between alcohol use, firearm access and suicide risk

> **NIH NIH R01** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2024 · $794,155

## Abstract

PROJECT SUMMARY/ABSTRACT
Nearly 60% of firearm-related deaths are suicides, and over half of suicide deaths involve firearms. Further nearly
half of firearm suicide decedents were intoxicated at the time of their death. Therefore, alcohol is a key modifiable
risk factor for reducing firearm suicide, which is essential to ameliorating the public health crises of suicide and
firearm violence. While alcohol and firearm access have been studied as distinct risk factors for suicide, the three
have yet to be integrated into a single coordinated line of research that leverages multiple methods to understand
their linkages. One challenge is the lethality of firearm suicide, which leaves few survivors to study. Many people
contemplate firearm suicide, however, and this group provides a key opportunity to understand people who die
by firearm suicide. Preliminary analyses with our existing survey data suggests about 10% of people have
contemplated firearm suicide, and 7% report firearm suicidal ideation and a binge drinking episode in the last
month. We also find reliable associations among past suicide attempts, current suicidal thoughts and behaviors,
and alcohol use problems that varies with the ‘intensity’ of gun ownership. That is, people with more experience
with firearms and who engaged in more gun carrying reported more suicidal thoughts and behaviors, with a
subgroup of high-risk gun owners who exhibit numerous risk factors for firearm suicide and violence including
problematic alcohol use. Further, timeline follow back studies of recent suicide attempts find the strongest risk
factor is recent alcohol use. We propose three aims focused on understanding firearm suicidal ideation and the
role of alcohol and firearm access. First, we will conduct a nationally representative survey using probability
sampling focused on suicide risk, alcohol use problems, and firearms to test new hypotheses and provide more
definitive findings on the intersection of alcohol use, firearm access, and suicide at the population level. Second,
we will build on these analyses by conducting focus groups and qualitative research of people who have seriously
considered suicide by firearm. We will use mixed methods to identify themes that characterize pathways to
firearm suicide (as well as safety towards help seeking) with an emphasis on the role of alcohol use among
people with a history of firearm suicidal ideation and problematic alcohol use. These findings will be used to
design and develop content for a process-orientated study using ecological momentary assessment (EMA) to
study the dynamics of firearm suicidality and alcohol use in real time. The EMA study will be conducted for 28
days among participants who report recent firearm suicidal ideation and problematic alcohol use and who own
or have access to a firearm. Key goals will be to determine the variability of firearm suicidal ideation and how
this covaries or is moderated by alcohol use and ease of access to firearm...

## Key facts

- **NIH application ID:** 10938880
- **Project number:** 1R01MH137443-01
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** BRIAN M HICKS
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $794,155
- **Award type:** 1
- **Project period:** 2024-08-01 → 2025-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10938880

## Citation

> US National Institutes of Health, RePORTER application 10938880, Determining the links between alcohol use, firearm access and suicide risk (1R01MH137443-01). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10938880. Licensed CC0.

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