Family history of drug problems as a marker for other health risks in primary care patients

Abstract

Aims: The study aim is to determinewhether risk behaviors and mental health history differ by family history of drug problems. Methods:N=3253participantswere recruited from thewaiting room of a hospital-based primary care clinic as part of a larger drug and alcohol Screening Brief Intervention and Referral to Treatment (SBIRT) study. Using a small tablet computer in the clinic waiting room participants completed an interactive, computer-delivered screening and assessment, including questions about demographics,mental health history, partner violence exposure, substanceuse behaviors and family history of substance use. Participants were classified into 4 groups based on their report of family members’ history of problems with drugs: (1) no family history; (2) second degree only (grandparents); (3) first degree only (parents and siblings); and (4) first and second degree. Logistic regression analyses were used to compare the four groups on multiple risk factors, with no family history as the reference group. Age, gender, and race were added as covariates in adjusted models. Results: Participants were predominantly mid 40’s (mean 46.6, SD 12.25), women (73%), and Black (72%). Family history of drug problems was associated with current smoking [1◦ AOR 1.8 (1.54, 2.11)], positive alcohol CAGE [1◦ AOR 2.6 (2.02, 3.36); 1◦ & 2◦ AOR 7.5 (3.72, 15.21)], positive drug CAGE [1◦ AOR 4.2 (3.06, 5.76); 1◦ & 2◦ AOR 7.0 (3.04, 15.99)], past year violence victimization [1◦ AOR 1.8 (1.37, 2.28); 1◦ & 2◦ AOR 5.5 (2.99, 10.08)], and previous diagnoses of anxiety [1◦ AOR 1.8 (1.37, 2.28); 1◦ & 2◦ AOR 5.5 (2.99, 10.08)] and depression [1◦ AOR 1.8 (1.37, 2.28); 1◦ & 2◦ AOR 5.5 (2.99, 10.08)]. Conclusions: Family history of drugproblems is associatedwith increased odds for substance use, violence exposure, and mental healthdiagnoses inprimary carepatients. This risk appears additive as high density family history of drug problems (first and second degree relatives) was associated with the highest risk. Financial support: RO1 DA026091, 5K23AA020316-02.