Elizabeth Maloney and Shane Darke
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
Suicidal Behavior in Alcohol and Drug Abuse and Dependence. Hauppauge, New York: Nova Science Publishers, 2010, 540 pages.

Elevated rates of attempted suicide have been reported among substance dependent individuals compared to the general population. Attempted suicide is associated with substantial morbidity and significant risk of subsequent mortality, with this risk increasing for each attempt. Attempted suicide is clearly an issue deserving of clinical and research attention. To date, however, attempted suicide has received relatively limited research attention. The literature suggests that attempted suicide affects substance users in general, rather than being contained to a particular drug class. This review summarises the risk factors for suicide attempts among individuals with substance use disorders including sociodemographic factors, family dysfunction and childhood experiences, and comorbid psychopathology. This review also distinguishes self-mutilation as a distinct behaviour from attempted suicide with self-mutilation remaining a poorly understood and understudied phenomenon, and examines the prevalence and risk factors associated with self-mutilation among substance users. Additionally, the clinical characteristics associated with the co-occurrence of suicide attempts and self-mutilation are discussed, including what this may mean for treatment. Finally, the clinical implications associated with assessment and treatment of suicidal behaviours are discussed.