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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 post-treatment assessment.

Methods: A national sample of 8,807 patients presenting for treatment of substance use disorders (SUD’s) in the US 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.

Research report; Predictors of a suicide attempt one year after entry into substance use disorder treatment. Ilgen MA, Harris AH, Moos RH, Tiet QQ. Alcohol Clin Exp Res 2007; 31(4): 635-42.

See also;

• Strategies for Dealing With Crises
• Brief-TSF is designed to address these issues.

Alcohol and Suicide: Research and Clinical Perspectives by Leo Sher, Isack Kandel, Joav Merrick Read more about this title…

Addiction Treatment Cuts Crime, Boosts Employment, Kentucky Research Concludes

Providing addiction treatment saves the state of Kentucky $10 million annually, or $4.98 for every dollar spent providing services, according to a new report from the Center on Drug and Alcohol Research at the University of Kentucky.

The Lexington Herald-Leader reported July 16 that researchers who followed up with 906 participants in publicly funded treatment programs one year post-discharge found that they committed fewer crimes, made more money at work, and used less alcohol and other drugs.

“It suggests that treatment services not only benefit the individual but serve society at large,” said study author Robert Walker.

Walker and colleagues found that 72 percent of the patients studied abstained from alcohol use during the past month, and 88 percent were abstinent from illicit drugs. Forty-seven percent had full-time jobs, compared to 29 percent prior to treatment, and 30 percent had been arrested, compared to 57 percent in the year before treatment.

“The research certainly supports moving toward more of a community-based treatment approach rather than incarceration,” Walker said.

The state hasn’t increased funding for its main addiction treatment providers in 12 years, however, and State Senate Judiciary Chairman Robert Stivers offered only a qualified endorsement for more funding. “We have to discern the profiteers from the individuals who are addicted,” Stivers said.

See also;

• Narcotics Anonymous
• BriefTSF is designed to help breakdown denial
• 12-Step Treatment More Effective than Alternative

Slaying the Dragon: The History of Addiction Treatment and Recovery in America by William L. White Read more about this title…

The Co-Occurring Center for Excellence. Addressing mental disorders and alcoholism, addiction co-occurring.

The Co-Occurring Center for Excellence (COCE) was created by SAMHSA in 2003 to provide information and a range of services to mental health and substance abuse administrators and policymakers at state and local levels, their counterparts in tribal and Native populations, clinical providers, other providers, and all other agencies and systems through which clients may enter the treatment system.

COCE provides state-of-the-art and sustainable technical assistance, training, information and resources, and links to other resources that serve persons with co-occurring disorders.

http://www.coce.samhsa.gov/

See also;

• Double Trouble in Recovery
• Dual Diagnosis Anonymous
• Double Trouble in Recovery for Alcoholics
• 12-Step Treatment More Effective than Alternative

The Dual Diagnosis Recovery Sourcebook : A Physical, Mental, and Spiritual Approach to Addiction with an Emotional Disorder by Dennis Ortman Read more about this title…

Treatment response of bipolar and unipolar alcoholics to an inpatient dual diagnosis program

BACKGROUND: Depressed and bipolar alcoholics represent a significant affective subgroup that has a poorer prognosis than either diagnosis alone. To date few systematic treatment programs have been developed to treat dual diagnosis.

METHODS: An inpatient treatment program was developed at St Patrick’s Hospital Dublin to treat dual diagnosis clients with alcohol dependence and either unipolar or bipolar affective disorder.

Clients (N=232) were assessed for depression, anxiety, elation, cravings, drink and drug intake on admission, discharge, 3 and 6 months post-discharge from the program.

RESULTS:

• In the overall group there was a reduction in number of drinking days and units per drinking day over the study (p<.01).
• There was a 71.8% complete abstinent rate at 3 months and 55.8% at 6 months in the depression group, non-significantly greater than for the bipolar group at 64.7% and 54.1% respectively.
• Gamma GT, MCV and craving scores were significantly reduced over time (p<.01).
• Mania, depression and anxiety inventory scores fell over time in both groups (p<.01).
• 15-21-year olds were more severely anxious, had higher illicit drug use, and were more likely to relapse to drug use than older clients.
• Bipolar 1 clients were significantly more likely than bipolar 2 clients to be on mood stabilisers at all follow-up stages (p<.001).

LIMITATIONS: No control group was used.

CONCLUSIONS: There is evidence for efficacy of a specifically designed dual diagnosis inpatient treatment program as both depressed and bipolar alcoholics had significant reductions in all measurements of mood, craving, and alcohol/drug consumption by self report and biological markers, suggesting both diagnoses can be effectively treated together.

Research; J Affect Disord. 2008 Mar;106(3):265-72. Epub 2007 Aug 16. Treatment response of bipolar and unipolar alcoholics to an inpatient dual diagnosis program. Farren CK, Mc Elroy S.

See also;

• Brief-TSF can assist patients cease alcohol consumption.
• Disease Concept of Alcoholism
• Subscribe to BriefTSF by e-Mail

The Dual Diagnosis Recovery Sourcebook : A Physical, Mental, and Spiritual Approach to Addiction with an Emotional Disorder by Dennis Ortman Read more about this title…

Early treatment response in alcohol dependence with extended-release naltrexone.

OBJECTIVE: We sought to determine the time course for onset of effect of intramuscular injectable extended-release naltrexone (XR-NTX), which has demonstrated efficacy for alcohol dependence.

METHOD: A post hoc analysis of a randomized, double-blind, placebo-controlled, multicenter study was conducted. In the study, actively drinking men and women who met DSM-IV-TR criteria for alcohol dependence were randomly assigned to receive injections of XR-NTX 380 mg (N = 205) or 190 mg (N = 210) or placebo (N = 209) every 4 weeks for 24 weeks. Patients also received 12 sessions of adjunctive standardized, low-intensity psychosocial intervention. Drinking data were analyzed by month and, during the first month, by day to explore the time course for onset of effect on heavy drinking days in patients receiving XR-NTX versus placebo. The study data were collected between February 2002 and September 2003.

RESULTS: During the first month following injection, patients receiving XR-NTX 380 mg had 37% fewer heavy drinking days versus placebo (p < .01). By day 2, a significant reduction in the median number of drinks consumed per day was observed in patients given XR-NTX 380 mg compared with placebo (p < .05). By day 3, XR-NTX 380 mg resulted in a significant reduction in the percentage of patients reporting heavy drinking compared with placebo (p < .05); this reduction was maintained throughout the study. A dose-response effect was observed, with intermediate results for XR-NTX 190 mg.

CONCLUSION: XR-NTX 380 mg provided a rapid onset of therapeutic effect in the first 2 days after the first injection that was sustained throughout the 24-week trial. Potential clinical implications of the rapid, early onset of effect of this medication’s delivery system for patients who are dependent on alcohol include facilitation of early engagement in treatment, motivation to continue treatment, and focus on the goals established in counseling.

Research; J Clin Psychiatry. 2008 Feb;69(2):190-5. Early treatment response in alcohol dependence with extended-release naltrexone. Ciraulo DA, Dong Q, Silverman BL, Gastfriend DR, Pettinati HM.

See also;

• Twelve-Step Programs as an Adjunct to Psychotherapy and Psychopharmacology
• Subscribe to BriefTSF by e-Mail

Training; Domestic Violence and Substance Abuse

Description:

This course is designed for Substance Abuse Counselors and Professionals in the Social Service field with an overview of domestic violence and substance abuse.

This education course will cover various forms of domestic violence, identification of risk factors and causes, intervention and treatment approaches.

http://www.nattc.org/addictionEd/courseDetail.asp?org=262&CourseID=1401

See also;

• Twelve Step Facilitation