2. Physicians, who have easy access to controlled substances, may start self-medicating with those and find themselves in a lot of trouble with drug abuse. Looking at so-called "psychological autopsies" on physician suicides, a very high percentage have alcohol or drugs in their system, and many have abused drugs or alcohol shortly before their death. Alcohol and drugs impair cognition, decrease inhibition and increase impulsivity. Many suicides are an impulsive reaction to situational events. Individuals whose judgement is not impaired have a better chance of using their other coping skills to avoid suicide.