“…Substance use can also compromise the effectiveness of pharmacotherapy interventions by causing serious side effects, potentiating effects of some psychotropic medications (thereby increasing risk of overdose), and decreasing adherence to medication regimens (Catz, Heckman, Kochman, & DiMarco, 2001; National Institute on Alcohol Abuse and Alcoholism, 2005). Finally, alcohol and substance use are associated with increases in suicidal ideation and suicide attempts, shifting intervention efforts to crisis management rather than other therapeutic goals (e.g., Claassen et al, 2007; Goldstein & Levitt, 2006; Shen et al, 2006).…”