BACKGROUND: When evaluating an emergency department (ED) patient who presents with suicidal ideation, it is a common practice is to wait until the ethanol level is known or calculated to be less than 80 mg/dL to evaluate patient safety. We are not aware of any study that establishes the association between the degree of alcohol intoxication based on blood alcohol levels (BALs) and reported suicidal ideation (SI) upon recovery.
METHODS: This study is a retrospective review of patients evaluated in a pre-COVID Midwestern ED for one calendar year. Cases were selected based on the criteria of having a Psychiatric Social Work (SW) consult and blood alcohol level drawn while in the ED. Patients were selected from the same two days each week in 2017 to meet the sample size requirements of the study, resulting in 1084 cases for review. Chi-square analysis was used for comparison of variables of suicidal ideation with or without alcohol intoxication as defined by blood alcohol level (BAL) ≥ 80 mg/dL.
RESULTS: Patients presenting with suicidal ideation and concurrent alcohol levels ≥ 80 mg/dL were no longer reporting suicidal ideation at blood alcohol level < 80 mg/dL in 69% of cases, compared to 38% for patients without alcohol levels on presentation (Chi-square, p=0.000012).
CONCLUSION: Our data suggest that patients presenting to the ED with complaints related to suicidal behavior who are found to have concurrent BAL ≥ 80 mg/dL are more likely to deny suicidal ideation when they have a BAL < 80 mg/dL than patients with similar presenting complaints and no alcohol intoxication. This finding suggests confirmation of the common ED practice when assessing suicidal ideation in intoxicated individuals.