Abstract

Background Despite the knowledge that alcohol and drug use are risk factors for suicide, the change in outcomes from testing urine drug screens is a point of contention between emergency physicians and psychiatrists. The influence of alcohol levels on disposition from the emergency department has never been tested. Objectives The purpose of this study was to assess the utility of alcohol and UDS testing in SI patients, which may be more useful in this subset of patients than in mental health patients as a whole. Variables important for suicide risk such as age, a previous suicide attempt, a serious current attempt, stated future intent, current psychiatric treatment, and history of psychiatric hospitalization were controlled for using logistic regression. Methods Data on patients' disposition (admitted/transferred versus discharged), alcohol level, and Urine Drug Screens (UDS) were obtained in patients with suicidal ideation. Logistic regression with admission/transfer versus discharge was used to analyze the influence of alcohol and substance use on disposition. Results After controlling for other variables important for suicide risk, patients without evidence of alcohol use were admitted/transferred at higher rates compared to patients with evidence of alcohol use. Urine drug screens did not influence disposition. Conclusions Alcohol use was associated with final disposition in patients with suicidal ideation. The reasons for this are unclear. Although some patients with alcohol use may be better treated in an outpatient setting, it is also possible that emergency physicians are using alcohol levels to incorrectly discharge suicidal patients at presumably higher risk from the emergency department.

Authors and Affiliations