Alcoholism is associated with an increased risk for suicide, with suicide mortality rates for alcoholics that are approximately six times those of the general population (64, 94). In fact, abuse of substances including alcohol may be the second most frequent psychiatric precursor to suicide (147). Although suicide rates among alcoholics are higher in Europe and older literature indicated a lifetime risk for suicide in the 11%–15% range, recent literature suggests the lifetime risk of suicide among alcoholics in the United States is as low as 3.4%(148). In addition, in psychological autopsy studies, alcohol abuse or dependence is present in 25%–50% of those who died by suicide (59,149–151).