Outcomes of substance use disorder treatment in suicidal and nonsuicidal male patients

Objective: Numerous studies report high rates of substance-related problems and psychopathology in substance use disorder (SUD) patients with a history of a suicide attempt. However, little is known about the response of suicidal SLID patients to treatment. This study examined the treatment outcomes of suicidal and nonsuicidal SUD patients who were followed for 5 years. Method: A total of 2,099 male SUD patients were recruited from 15 Department of Veterans Affairs residential alcohol and drug treatment programs and were assessed at four points (treatment entry, discharge, and 1 and 5 years later). Approximately 7% (n = 156) of the patients reported a suicide attempt in the 3 months prior to the start of treatment. Results: Although patients with a recent suicide attempt reported severe patterns of alcohol use and elevated psychiatric symptoms at baseline, they showed significant improvements in both of these domains at discharge from residential treatment, and these improvements were still evident at 1-year and 5-year follow-ups. Suicidal SUD patients were no more likely to leave treatment early than were nonsuicidal patients, and they received slightly longer and more individualized treatment. Conclusions: Despite a more severe pattern of alcohol use and psychiatric symptoms at baseline, suicidal SUD patients benefitted substantially from residential SUD treatment. These findings imply that suicidal SUD patients can be treated effectively within SUD treatment settings.