Alcohol and drug use among patients presenting to an inner-city emergency department: A latent class analysis

Abstract

The inner city Emergency Department (ED) provides a window of opportunity for screening for alcohol and other drug misuse and substance use disorders (SUDs), in order to facilitate linkage for individuals who are in need of services targeting such issues. The majority of prior work in this area has focused on alcohol use. This study used latent class analyses to characterize substance use/SUDs among adults presenting to the ED for medical complaints or injuries. Participants (n=14,557; 77% participation; 45% male; 54% African-American) completed a computerized survey assessing demographics, health functioning, and substance use/SUDs. Although injured patients were significantly more likely to use tobacco, alcohol, and marijuana, and were more likely to have an alcohol use disorder, presenting complaint was not related to other drug use/diagnoses. Five latent classes were identified: (1) non users/SUDs (65.9%) (2) binge drinkers (24.3%), (3) marijuana users/SUD (3.5%), (4) cocaine users/SUD (2.9%), and (5) poly-drug users (3.3%). Compared to class 1, participants in the other classes were younger, male, without health insurance, with poor mental health functioning, tobacco users, and had prior substance use treatment. African-Americans were most likely to be in classes 3 or 4 and employed participants were most likely to be in class 2. In comparison to class 1, classes 2 and 3 reported better physical health; class 2 was more likely to present for injury whereas class 5 was more likely to present for a medical complaint. ED-based screening and interventions approaches need to address the co-occurrence of alcohol, illicit drug, and psychoactive prescription drug use.

Alcohol, tobacco, and drug use among emergency department patients

“…For example, tobacco smoking may be a convenient marker for other substance use problems, as patients often easily acknowledge smoking. Given the mixed results for the association of triage level with ATOD problems, our data also support expanding SBI to include non-trauma patients and non-trauma EDs, consistent with results reported by Blow et al (2011) who found that poly-drug users were more likely to present with medical problems than injuries.…”

Correlates of partner and non-partner aggression among patients with substance use disorders in an urban ED

“…Prior analysis of the sample has shown that there was frequent marijuana use across whole sample (Blow et al, 2011) and another research has shown that acute marijuana intoxication can decrease aggression . Additional research is needed to better understand both social contextual factors and substance use problems as they relate to partner and non-partner violence.…”

Patterns of concurrent alcohol, tobacco, and cannabis use in Germany: Prevalence and correlates

“…Much research on the prevalence of MSU has been conducted in clinical samples (Blow et al, 2011;Byqvist, 1999;Martin, Kaczynski, Maisto, & Tarter, 1996), university samples (Barrett, Darredeau, & Pihl, 2006;Martin, Clifford, & Clapper, 1992) or youth samples (Collins et al, 1998;Merrill, Kleber, Shwartz, Liu, & Lewis, 1999). Fewer studies have assessed MSU in the general population.…”