The mortality rate among drug users is higher than that of the general population. There is some evidence that the risk of suicide is also higher, although major methodological difficulties tend to cast doubt on their accuracy. The factors generally known to be associated with suicide such as mental and physical health problems, poor family relationships, social isolation and stressful life events are also associated with drug misuse. Illicit drugs may be used as a form of self-medication for anxiety and depression, but this draws an individual into a life that is likely to increase stress levels. For a drug user already stigmatized and detached from conventional society, becoming HIV positive can lead to greater stress and isolation. The impact of HIV on individuals physically and psychologically damaged by drug misuse is difficult to predict. There is little research that is attempting to determine who is most at risk and the nature of the factors that will predict an attempt at self-harm. If those who are most likely to attempt suicide are to be detected and adequate care provided by health professionals, risk and protective factors need to be identified in drug-using communities in which HIV is present or likely to occur.