Ioana Todor
University of Alba Iulia, Romania
Suicidal Behavior in Alcohol and Drug Abuse and Dependence. Hauppauge, New York: Nova Science Publishers, 2010, 540 pages.

Suicidal behavior has a complex and multidimensional etiology, being the product of a large spectrum of biological, psychological, socio-cultural, interpersonal and situational factors. Alcohol and/or drug abuse is one of the causal factors of suicidal behavior. Other significant risk factors include: depression and associated mental disorders, history of suicide attempt(s), the existence of suicidal ideation, plan or intent, impulsivity and aggression, severely disturbing physical illnesses, negative life events, unrestricted access to lethal means, demographic and situational variables. Because of the strong statistical association between the two conditions, it is recommended that all the patients with alcohol/drug abuse should be carefully assessed for suicidal risk in primary care units. The assessment of suicidal risk is only the first step in prevention. According to their estimated suicidal risk, these patients are followed up at home, they are hospitalized, or they are oriented towards rehabilitation centers, mental health institutions or psychiatric units. The second step in prevention of suicidal risk consists in the management of the risk factors, involving a wide range of techniques and strategies: from a non-harm contract and follow-up visits, enhanced psychosocial support, or counseling on specific problems, to individual or group psychotherapy, family therapy, and pharmacological treatment. The success of prevention depends on the collaborative efforts of family doctors, physicians with various specialties, psychiatrists, psychologists, social workers, educators, various health care professionals and community members.