title: Substance use-disorder treatment and a decline in attempted suicide during and after treatment.
abstract: OBJECTIVE
  Suicide attempts are common in patients being treated for substance-use disorders (SUDs). However, little is known about the frequency of suicidal behavior during and after SUD treatment or about aspects of treatment that predict subsequent suicidal behavior. The present study examines whether treatment setting, length of treatment, and availability/use of psychiatric services are associated with a reduced likelihood of a suicide attempt during and 1 year after treatment.
  
  
  METHODS
  A national sample of 3,733 patients was assessed at the start of an episode of SUD treatment and again at discharge and/or 1 year after treatment. Mixed-model logistic regression analyses examined treatment-related predictors of in-treatment and posttreatment suicide attempts.
  
  
  RESULTS
  The rate of suicide attempts was significantly lower in the year following treatment (4%) than in the year before treatment (9%). Additionally, a total of 2% of patients reported a suicide attempt during treatment. Suicide attempts made during treatment were less likely in patients treated in residential as compared with outpatient settings. A longer course of treatment was associated with a lower likelihood of a posttreatment suicide attempt.
  
  
  CONCLUSIONS
  A sizable minority of patients report a suicide attempt either during or within 1 year after completion of SUD treatment. Even after controlling for baseline suicidality, aspects of the SUD treatment episode are associated with a lower risk of a future suicide attempt. Treatment providers should consider placing patients in residential settings to reduce suicide attempts made during treatment and providing a longer course of treatment to reduce the likelihood of suicide following treatment.
authors.affiliation: Center for Health Care Evaluation, Department of Veterans Affairs Palo Alto Health Care System, 795 Willow Road (MPD 152), Menlo Park, California 94025, USA. Mark.Ilgen@va.gov
authors.forename: Mark A
authors.initials: MA
authors.lastname: Ilgen
authors.forename: Anuja
authors.initials: A
authors.lastname: Jain
authors.forename: Emma
authors.initials: E
authors.lastname: Lucas
authors.forename: Rudolf H
authors.initials: RH
authors.lastname: Moos
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology / Q000534:rehabilitation*; D019970:Cocaine-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation*; D016578:Crack Cocaine; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016013:Likelihood Functions; D008137:Longitudinal Studies; D008297:Male; D013223:Statistics as Topic; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation*; D013406:Suicide, Attempted / Q000517:prevention & control* / Q000706:statistics & numerical data; D014481:United States
chemical_list: D016578:Crack Cocaine