March is Self-Harm Awareness Month, a subject closely linked to substance abuse. Both are often the result of a poor coping mechanism for dealing with stressful situations, used to serve as a distraction or create a feeling of control, and have overlapping risk factors. With so many similarities, it’s not surprising that there are also several close correlations such as their underlying risk factors or rates and the presence of one with the other.

What is self-harm?

Self-harm is when a person deliberately injures themselves. The difference between self-harm and suicide is that most self-harmers do not intend to end their lives, although about half of suicide cases engaged in self-harm at some point. 

Forms of self-harm

There are many forms of self-harm, some of the most common are:

  • Cutting or piercing the skin with a sharp object
  • Hitting or punching themselves or objects 
  • Burning themselves
  • Breaking bones or bruising oneself
  • Pulling out hairs
  • Picking at wounds to prevent them from healing

Intersectionality of Drug Use and Self Harm

People who use drugs face a higher risk of self-harm and suicide. Conversely, about one in five people who self-harmed were under the influence of drugs at the time. This can partially be explained by the effects that drugs have on a person; inhibitions are lower, depression symptoms are heightened, and decision-making is impaired. For this reason, sometimes drug use can mask self-harm intentions, which can make it difficult to identify someone who might pose a danger to themselves. 

Shared Risk Factors

There are many acute risk factors that are shared between self-harm and substance abuse. Individuals who engage in either often feel overwhelmed, sad, or frustrated beforehand. However, both drugs and self-harming behaviors have been shown to have deeper-rooted risk factors tied to intensely stressful experiences such as:

  • Bullying
  • Neglect
  • Death of a loved one
  • Emotional, physical, or sexual abuse
  • Familial substance abuse
  • Loss of one or both parents
  • Trauma

Another prominent commonality between these two behaviors is the co-occurrence of mental illness. Anxiety, bipolar disorder, depression, Eating disorders, gender dysphoria, PTSD, and schizophrenia are some of the most common.

Specific drugs and different types of self-harm

Substance abuse and self-harm can be destructive on their own but their danger is exponentially amplified when combined. Some drugs have stronger associations with self-harming behavior than others, with some combinations of self-harm and substance resulting in specific patterns of use. Being aware of the patterns can give greater insight into the reason why a person might engage in these dangerous behaviors. 


Being both a stimulant and depressive, alcohol can increase the likelihood of self-harm and its severity in several ways. One: Intoxication impairs judgment and coordination, making it physically more likely that a person hurts themselves more seriously than they initially intended. Two: alcohol can also increase aggression and mood changes, heightening negative feelings that contribute to a desire to self-harm.


Hallucinogens are psychoactive drugs that can greatly alter how a person perceives reality. These include drugs like LSD, PCP, ketamine, and ecstasy. Often associated with parties, sometimes hallucinogens are anything but a good time. Bad trips can result in intense anxiety, paranoia, and delusions; a person may feel like they’re losing control of themselves; and on rare occasions, may even result in seizures.

Sudden and drastic mood swings paired with altered sights, sounds, smells, feels, and tastes make for a dangerous combination. A person may unknowingly cause themselves harm or could end up doing so intentionally due to a sudden onset of rage or aggression. 


This class of drugs is composed of substances like Vicodin, OxyContin, Percocet, and fentanyl. Opioids are exceptionally efficient painkillers and several are also used to treat anxiety. Research has found that the risk of self-harming behavior increases in the weeks immediately following the end of opioid usage. 

Why Self-Injury Awareness Matters

As many different types of self-harm as there are, there are as many ways to hide this destructive behavior. Recognizing the signs can potentially be life-saving, and drug use can be one of those signs. Other common signs of self-injury include:

Avoiding situations that would require exposing skin (e.g., swimming).

Bald spots or patches (indicative of hair-pulling)

Constantly wearing bandages

Having sharp objects around without reason

Lying about where injuries came from

Numerous unexplained cuts or bruises 

Wearing pants or long-sleeved tops, even in really hot weather

Withdrawal and isolation

If you have a loved one that is engaging in either behavior, seek help immediately. Substance abuse and self-harm only make things worse and can perpetuate a negative and debilitating cycle. Find a drug rehab near you, today.