Teenagers who frequently binge-drink are more likely to commit suicide in their 20s, alarming new research shows.
Those admitted to hospital with alcohol-related injuries face a five-fold increased risk of killing themselves, it suggests.
The findings also applied to those who required medical treatment from taking drugs, being involved in violence and self-harm.
Professor David Cottrell, from the University of Leeds, who was involved in the research, warned that the NHS must do more to help these teenagers.
He said: "Clinicians have not fully appreciated the risks facing children and young people who arrive in hospital emergency departments having suffered an adversity-related injury.
"It is well established that children who self-harm are at an increased risk of suicide. But the research points to that fact that the risk extends to a much broader group.
"Children and young people who suffered injuries through drink or drugs or violence also faced an increased risk of suicide or premature death through alcohol and drug behaviours."
Sarah Brennan, chief executive of Young Minds, said: "This groundbreaking research demonstrates some of the interconnections between self-harm, substance misuse and violent injury - and the tragic consequences that these experiences may have.
"It is essential that we don't think of young people simply in terms of a list of 'issues', and that we understand how distress can be expressed in different ways at different times."
For the study published in The Lancet, the researchers, who teamed up with University College London, looked at anonymous data on more than a million youngsters over 15 years.
All participants were aged between 10 and 19 and had been admitted to various A&E departments across the UK.
Those whose injuries were due to 'adversity' - the result of drug or alcohol abuse, violence of self-harm - were twice as likely to die within the next decade.
This was compared to people who were injured in bog-standard injuries.
Young people in this adversity group were also found to be five times more likely to kill themselves in the forthcoming 10 years.
The exact suicide risk was found to be 7.2 per 1,000 for boys. However, for girls it was much lower at 2.5 for the same amount.
In comparison, the rate was 1.2 and 0.4 respectively for those who weren't in the adversity group,
reports.
The findings reflect the widely known fact that men are almost four times more likely to commit suicide than women.
Two thirds of all recorded deaths were attributable to suicide, drug or alcohol abuse, or homicide, the study showed.