Predictors of a suicide attempt one year after entry into substance use disorder treatment

Background: The present study examined the patient intake and treatment-related risk factors associated with a suicide attempt in the 30 days before a 1-year posttreatment assessment. Methods: A national sample of 8,807 patients presenting for treatment of substance use disorders (SUDs) in the Department of Veterans Affairs healthcare system were assessed at treatment intake and follow-up. Using the MacArthur Model, the risk and protective factors for suicide attempt were identified at baseline and during treatment. Results: At follow-up, 4% (314/8,807) of the patients reported a suicide attempt within the past 30 days. Baseline predictors of a suicide attempt before follow-up included elevated suicidal/psychiatric symptoms, more recent problematic alcohol use, and longer duration of cocaine use. Contact with the criminal justice system was a protective factor that reduced the likelihood of a future suicide attempt. Greater engagement in SUD treatment was also associated with a reduction in suicide risk. Conclusions: More involvement in SUD treatment reduced the likelihood of a future suicide attempt in high-risk patients. Substance use disorder treatment providers interested in reducing future suicidal behavior may want to concentrate their efforts on identifying at-risk individuals and actively engaging these patients in longer treatment episodes.