Gambling With Your Life: Rethinking the Notion of Russian Roulette as Suicide with 20 Years of National Violent Death Reporting System Data

Session Title

Gambling & Mental Health Crises

Presentation Type

Paper Presentation

Start Date

27-5-2026 12:00 AM

Abstract

Russian Roulette (RR), recently popularized in media, has been termed the “ultimate gamble with death,” in which individuals seek to prove themselves through an act of extreme risk-taking. However, there is limited research on this phenomenon, which is classified by the Centers for Disease Control (CDC) as suicide. This study examined a range of factors critical to understanding who dies by RR and whether RR should be considered a suicide, rather than the accidental outcome of risky behavior. We analyzed 37,411 cases of male revolver deaths classified as suicide from the CDC’s National Violent Death Reporting System’s Restricted Access Datafile from 2003 to 2022. A review of coroner/medical examiner and law enforcement narratives identified 525 RR cases. Bivariate associations and regression analyses examined differences between RR and non-RR deaths. Findings identified a distinct profile of those who die by RR, including younger age (mean age=28.49 vs. 59.02), lower education, and being Black, American Indian/Alaskan Native, and/or Hispanic. Mental health issues and common precipitating factors for death by suicide were significantly lower, while positive toxicology for alcohol, amphetamines, opiates, and marijuana were significantly higher among individuals who died by RR. Overall, only 17.9% of RR deaths appeared to be suicides with clear intent, underscoring the need to revisit classification of this phenomenon.

Author Bios

Ryan DiMeglio, LCSW, LCADC is an Assistant Professor and Co-Director of the Addiction Counselor Training Certificate Program at the Rutgers School of Social Work. Mr. DiMeglio focuses on the education of MSW students in preparation for careers in clinical practice treating addictive disorders, including gambling. Mr. DiMeglio is also a Ph.D. student at Rutgers and his research focuses on gambling, substance use disorders, addictive behaviors, and clinical treatment interventions.

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May 27th, 12:00 AM

Gambling With Your Life: Rethinking the Notion of Russian Roulette as Suicide with 20 Years of National Violent Death Reporting System Data

Russian Roulette (RR), recently popularized in media, has been termed the “ultimate gamble with death,” in which individuals seek to prove themselves through an act of extreme risk-taking. However, there is limited research on this phenomenon, which is classified by the Centers for Disease Control (CDC) as suicide. This study examined a range of factors critical to understanding who dies by RR and whether RR should be considered a suicide, rather than the accidental outcome of risky behavior. We analyzed 37,411 cases of male revolver deaths classified as suicide from the CDC’s National Violent Death Reporting System’s Restricted Access Datafile from 2003 to 2022. A review of coroner/medical examiner and law enforcement narratives identified 525 RR cases. Bivariate associations and regression analyses examined differences between RR and non-RR deaths. Findings identified a distinct profile of those who die by RR, including younger age (mean age=28.49 vs. 59.02), lower education, and being Black, American Indian/Alaskan Native, and/or Hispanic. Mental health issues and common precipitating factors for death by suicide were significantly lower, while positive toxicology for alcohol, amphetamines, opiates, and marijuana were significantly higher among individuals who died by RR. Overall, only 17.9% of RR deaths appeared to be suicides with clear intent, underscoring the need to revisit classification of this phenomenon.