It seems sometimes that alcoholism, binge drinking and drug-taking are thought of as a peculiarly British disease, with the media full of reports about the rampages of the young and not-so-young under the influence both home and abroad.
As Men's Health Week begins (15-21 June) it's an appropriate time for us to reflect on the fact that it's especially men who seem to use drugs and alcohol as a way of avoiding the difficult and painful feelings in their day-to-day lives.
65% of suicides involve alcohol but the relationship between suicide, drugs and alcohol is not really fully understood. Does drinking cause the downward spiral? Is drinking part of the downward spiral or is it a reaction to someone's life spinning out of control? Is it all these things depending on people's unique experiences?
Men are more likely to use alcohol and drugs to self-medicate* and those in the most deprived groups in society are more likely to suffer alcohol-related problems.**
Research tells us that some men tend to use alcohol as a long term crutch to get them through tough emotional times, and they are less likely to seek help unless they reach a crisis. This means that by the time someone comes to the attention of NHS or other support services they may already be dealing with complex and entrenched problems.
Joining up alcohol and drug misuse strategies with suicide prevention is crucial to unpicking the toxic relationship between masculinity, deprivation, drinking and suicide risk, as our Manifesto outlined last month.
Becoming dependent on alcohol or drugs can sneak up on you and become a major issue almost without you realising. Matt, 29, found it was not the escape from his problems that he was hoping for.
"I used Ecstasy to block the thought process - a collage of images and bad thoughts would go through my brain, making me feel crushed," said Matt. "For me, I could pop this pill and it would break my head open, and everything would be great."
"However, it became a series of terrific highs and terrible lows, and if you want to function well you have to be in balance," Matt said. "I was trying to live a normal life and take drugs and it just wasn't working.
"It became a continuous cycle where I thought I can't carry on like this, and it felt like the only way out was suicide. I hit a crisis at work one day and walked out, and it was then I came across Samaritans in Oxford Road, Manchester, which was a turning point."
Matt got help and has been able to break his addiction.
"Don't be afraid to seek help, go to the doctor or contact a service like Samaritans for emotional support. It's a matter of education too about the differences between street drugs and psychiatric drugs," said Matt who found anti-depressants helped him turn the corner on the road back to health.
Alcohol can be a particular problem because it is so accessible and is a socially acceptable way of managing emotions.
The risk of suicide is around eight times greater when alcohol is involved and too often the harm caused by alcohol is overlooked when it comes to suicide.
There is a proven connection between alcohol misuse and suicidal behaviour which needs to be reflected in the Government's approach to health policy.
Research has found that just one session of heavy drinking can reduce inhibitions sufficiently to make it more likely that someone will act on suicidal feelings, and drinkers are more prone to impulsive behaviour. Alcohol is also known to deepen depression.
We need to tackle individual behaviour which causes men in particular to turn to alcohol and drugs to blot out their emotional problems, rather than seek more constructive forms of help, and change the culture which normalises problem drinking.
Samaritans is available round the clock, every single day of the year. We provide a safe place for anyone struggling to cope, whoever they are, however they feel, whatever life has done to them. Please call 08457 90 90 90 (UK) 116 123 (ROI), email email@example.com, or visit www.samaritans.org to find details of the nearest branch.
References: *Amy Chandler, Masculinities and Suicidal Behaviour Men, Suicide and Society, 2012, p118
**Dolan, 2011, Green et al, 2010 p1484