Alcohol use, risk of suicide, and access to firearms among youth in Colorado.

Firearms are the leading cause of death for U.S. children under 18 years of age, driven by their use in suicide attempts. Alcohol use is a risk factor for suicide, and approximately 22% of U.S. high school students reported recent alcohol use. We used data from a population-based health survey of high school students in Colorado, weighted to be representative of public high school students, to examine the association of alcohol use and suicide risk, and access to firearms using weighted frequencies and Rao-Scott chi-square tests. One-fifth (20.3%) of the students reported drinking alcohol in the past 30 days. Compared to non-drinkers, students who reported drinking in the past 30 days were significantly more likely to report that they seriously considered attempting suicide (20.4% vs 8.9%, p < 0.001), made a plan to attempt suicide (17.0% vs 7.4%, p < 0.001), had actually attempted suicide (11.1% vs 3.9%, p < 0.001) and indicated that they could obtain and be ready to fire a loaded gun, regardless of adults' permission (29.0% vs 16.9%, p < 0.001). Given the distinct and combined risks of alcohol use and firearm access, the intersection is an important point for suicide prevention. Parents and guardians of youth may constitute an important population for means safety training.