Treating individuals with substance-abuse disorders who have attempted suicide

  • A considerable percentage of individuals with substance-use disorders (SUDs) attempt suicide.
  • A new study investigates if treatment setting inpatient or outpatient has a different impact on outcomes for suicidal and nonsuicidal patients with SUDs.
  • Suicidal patients receiving inpatient, compared to outpatient, SUD treatment were significantly more likely to have better substance-related, but not psychiatric, outcomes following treatment.
  • The study did not show clinically significant differences in outcomes for inpatient vs. outpatient care among individuals with SUDs who had not made a suicide attempt.

Reported rates of suicide attempts by individuals with substance-use disorders (SUDs) range from three percent in the previous 30 days to lifetime rates of 45 percent. Despite this relatively high frequency of suicide attempts by substance users, the effects of treatment following a suicide attempt are not well understood. A study in the September issue of Alcoholism: Clinical & Experimental Research investigates if treatment setting inpatient or outpatient has a different impact on outcomes for suicidal and nonsuicidal patients with SUDs.

"Historically, substance-abuse treatment was usually provided in inpatient settings," explained Mark A. Ilgen, a researcher at the Department of Veterans' Affairs (VA) Palo Alto and corresponding author for the study. "During the last few years, there has been a push to expand treatment options into more outpatient settings, largely as a cost-containment measure. Once that started, people began to ask: 'well, if it seems to work in outpatient settings, why even provide inpatient treatment?' So the pendulum has swung from being very focused on inpatient treatment to now being more focused on outpatient treatment. This may not be beneficial for certain groups, prompting the question: 'for whom is the treatment setting either more or less important?'"


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