History of suicidality and alcohol craving trajectories during inpatient treatment for alcohol use disorder. (1st April 2020)

• Record Type: Journal Article
• Authors: Janakiraman, Roshni; Gowin, Joshua L.; Sloan, Matthew E.; Schwandt, Melanie L.; Diazgranados, Nancy; Ramchandani, Vijay A.; Kwako, Laura E.
• Is Part Of: Drug and alcohol dependence. Volume 209(2020)
• Publication Date: 2020-04-01
• Subjects: Alcohol -- Suicide -- Craving -- Addiction; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2020.107918
• Languages: English
• ISSNs: 0376-8716

Abstract

Highlights: Craving levels were measured weekly throughout inpatient AUD treatment. Suicide attempt history predicted higher craving levels. Higher craving levels were also associated with greater alcohol use and comorbid psychopathology. Abstract: Background: Alcohol use is associated with an increased risk of completed suicide, but it is unclear whether past suicidality affects the course of alcohol use disorder (AUD). We examined whether a history of suicidal ideation or attempts is associated with treatment response in individuals with AUD. Methods: 146 participants underwent inpatient detoxification and residential treatment for AUD. Reductions in craving during treatment were used as an index of treatment response. Participants were assessed for history of suicidality using the Columbia-Suicide Severity Rating Scale and divided into three groups: no history of suicidal ideation or attempts (N = 76), history of suicidal ideation without attempts (N = 50), and history of suicide attempts (N = 20). Alcohol craving was measured weekly during treatment using the Penn Alcohol Craving Scale and compared across groups. Results: Individuals with a history of suicide attempts showed higher levels of craving throughout treatment compared to those without a history of suicidality. Associations between past suicide attempts and craving remained significant after adjusting for age, sex, alcohol use disorder severity, comorbid psychopathology, and benzodiazepine treatment. Participants in all groups had significant reductions in alcohol craving by the end of treatment. Conclusions: Our findings suggest that a history of suicide attempts is associated with higher levels of craving throughout inpatient treatment for AUD. These results support current guidelines on assessing suicidal ideation in patients with substance use disorders.