Treatment setting and suicidality in patients with substance use disorders

Ilgen M, Tiet Q. Treatment setting and suicidality in patients with substance use disorders. Paper presented at: VA HSR&D National Meeting; 2004 Mar 1; Washington, DC.

Objectives: The present study was designed to test the hypothesis that the effect of treatment setting (inpatient or outpatient) on 6-month follow-up substance use would be greater for suicidal than non-suicidal patients.Methods: A national sample of patients presenting for treatment of SUDs in the VA System was selected to participate in the study. A total of 1290 participants were assessed for psychiatric and substance-related problems at baseline and 6-month follow-up.Results: Four percent (n = 53) of the sample reported having made a suicide attempt within the past 30 days at baseline and almost half of both suicidal (26/53) and non-suicidal patients (534/1230) were treated in inpatient settings. A significant interaction between baseline suicide attempt and treatment setting was found. Non-suicidal patients reported similar rates of abstinence when treated in inpatient or outpatient settings but suicidal patients were significantly more likely to be abstinent from all substances at 6-month follow-up (24/26; 92.3%) if they were treated in inpatient settings as compared to outpatient settings (16/27; 59.3%).Conclusions: Inpatient treatment was associated with better outcomes for suicidal patients and no effect of treatment setting was found for non-suicidal patients.Impact: Despite past research that has shown a strong association between suicidality and substance-related problems, suicidal patients displayed substantial improvement following SUD treatment and seem particularly responsive to treatment administered in inpatient settings.