Impact of alcohol intoxication on mortality and Emergency Department resource use in suicidal patients

In North America, suicide is among the leading causes of death in individuals aged 15-60. A research team aimed to determine whether an emergency department (ED) presentation for suicidal behaviour, accompanied by acute alcohol intoxication, was associated with increased six- month suicide or all- cause mortality compared with non- intoxicated presentations of suicidal behaviour.
A retrospective cohort study was conducted among adults (>/= 18 years) presenting to 16 EDs in Alberta, Canada, between April 2011 and March 2021. Suicidal attempts or self- harm were identified using International Classification of Diseases codes, 10 th Rev, Canadian Enhancement (ICD- 10- CA). Patients were classified as acutely intoxicated if they had relevant ICD- 10- CA codes or a blood alcohol concentration >/= 2 millimoles per litre (9. 9.2 milligrams per decilitre). Patients who died on arrival, were transferred, or were non- residents were excluded from the study. The primary outcome was six- month suicide mortality; secondary outcomes included all- cause mortality, use of involuntary holds, psychiatric consultations, admissions, and ED return visits. Median differences with 95% confidence intervals and unadjusted odds ratios (ORs) with 95% CIs were reported for continuous and categorical variables, respectively.
Among 58, 051 patients with suicidal behaviour or self- harm, 17, 17,488 (30%) were classified as intoxicated. Six- month suicide mortality was similar between intoxicated and non- intoxicated groups (0. 0.3% each; adjusted sub- distribution hazard ratio = 0. 98 [95% CI, 0. 73-1. 38]), indicating no significant association between alcohol intoxication and suicide- specific death. Intoxicated patients were more often male (58% vs 52%; OR 1. 26 [1. 22-1. 31]), arrived by ambulance (70% vs 50%; OR 2. 32 [2. 23-2. 41]) and were more frequently placed on involuntary holds (26% vs 16%; OR 1. 92 [1. 83-2. 00]). They had fewer hospital admissions (10. 8% vs 15. 4%; OR 0. 63 [0. 60-0. 67]), longer ED stays (411 vs 277 minutes; median difference = 134 minutes [127. 7-140. 3]), and higher ED return rates at 30 days (19. 8% vs 18. 3%; OR 1. 10 [1. 05-1. 15]) and six months (45. 8% vs 42. 1%; OR 1. 16 [1. 12-1. 20]).
The researchers conclude that acute alcohol intoxication among ED patients presenting with suicidal behaviour was not independently associated with higher six- month suicide mortality. Patients with acute alcohol intoxication had increased use of involuntary holds, longer lengths of stay, and more frequent ED return visits. Future work should explore other psychosocial and clinical factors, including substance use and psychiatric comorbidities, that may influence outcomes beyond the acute setting.
Source: Skoblenick, K., Yang, E., Wilson, M. P, Youngson, E., & Rowe, B. H. (2026). Impact of alcohol intoxication on mortality and emergency department resource use in suicidal patients. Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health, 27(1).