Drug users who have been victims of severe childhood abuse are at increased risk for suicide attempts, a new study concludes. Less severe abuse, or physical or emotional neglect, does not appear to increase the risk.

HealthDay reports the Canadian study included 1,600 people who used drugs. They found extreme childhood abuse, especially emotional or sexual abuse, was associated with a significantly increased risk of attempting suicide.

During the course of the study, 80 participants reported a total of 97 suicide attempts—a rate that is five times higher than in the general population, the article notes. Participants who suffered severe to extreme emotional abuse were 2.9 to 3.5 times more likely to attempt suicide than those who did not suffer such abuse. Those who suffered extreme sexual abuse were 2.5 to 2.8 times more likely to attempt suicide, while such attempts were 1.6 to 2 times more likely in those who had suffered extreme physical abuse.

The findings appear in the American Journal of Public Health. They show “how detrimental childhood trauma can be,” lead author Brandon Marshall of the Brown University School of Public Health, said in a university news release. “We saw extremely strong associations, which suggest that abuse has lasting mental health impacts well into adulthood.”  He advised care providers to screen for these types of abuse and intervene whenever they see a situation of severe abuse, regardless of what type it was.