PARS – Preventing Addiction Related Suicide: A Stepped-Wedge Cluster-Randomized Clinical Trial

At a glance

Funded by: NIDA 2016-2021
Principal Investigator(s): Kate Comtois Richard Ries
Research Team:
Research Setting: Community Addiction Intensive Outpatient Programs


Individuals with substance use disorders (SUDs) are at high risk for suicide. The Preventing Addiction Related Suicide (PARS) module is the first suicide prevention module developed with and for community substance use intensive outpatient programs (IOPs). PARS is a single 2- to 3-hour suicide prevention module designed to replace one IOP group session. PARS is organized by PowerPoint slides guiding a combination of didactic lessons and group discussions. Topics include the strong link between addiction and suicide, suicide myths and facts, common triggers of suicidal thoughts and behaviors, suicide risk and protective factors, warning signs of suicide, the overlap of overdose and suicide, how to prevent addiction-related suicide, and creating a safety card.


  • In a stepped-wedge cluster randomized clinical trial, counselors at intensive outpatient programs received two hours of training and then delivered PARS in their own groups. These trained counselors rated PARS as highly effective, feasible, and easy to incorporate into their usual workflow.
  • The PARS intervention significantly improved patients’ suicide knowledge, attitudes, and adaptive coping skills compared to treatment as usual.
  • The PARS intervention significantly improved counselors’ knowledge, attitudes, and confidence in treating patients with suicidal thoughts and behaviors.

Get Trained to Deliver PARS

​Consider completing the PARSWeb training. It is provided at a low cost in hopes of increasing access to this life saving intervention in Washington and across the country.


Ries RKLivengood ALHuh D, et al. Effectiveness of a Suicide Prevention Module for Adults in Substance Use Disorder TreatmentA Stepped-Wedge Cluster-Randomized Clinical TrialJAMA Netw Open. 2022;5(4):e222945. doi:10.1001/jamanetworkopen.2022.2945