Patterns Of Substance Use Disorders Research Articles

The prevalence of substance use disorders and associated characteristics among patients admitted to a psychiatric hospital in Botswana.

Substance use disorders (SUDs) have increased substantially across the globe, and has become one of the world's most significant public health and socioeconomic challenge. This study examined the prevalence and patterns of substance use disorders among patients admitted to the main psychiatric hospital in Botswana, the Sbrana Psychiatric Hospital. This was a cross-sectional study of patients admitted to a major psychiatric hospital in Botswana. SUDs were assessed using the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) v13.0. Bivariate analysis was conducted to determine the association between socio-demographic characteristics and SUDs. Multivariate logistic regression was used to control for confounders. The final analysis involved 101 patients. Participants ranged in age from 18-60 years, and over half (59.4%) were male. The majority of participants (85.1%) had used potentially addicting substances at least once during their lifetime, with 63.4% having current substance use disorders. The most frequently used substances were tobacco, cannabis, alcohol, and cocaine at 58.4%, 42.6%, 34.7% and 12.8% respectively. SUDs were more common among participants who were male, ages 18-35 years, single, had a tertiary education, or were unemployed. There is a high prevalence of substance use and SUDs among psychiatric patients in Botswana. Screening for and interventions to manage SUDs should be part of routine care at psychiatric health care facilities in this country. Consideration should be given to the screening of all patients admitted to psychiatric hospitals in Botswana for SUDs using the ASSIST.

Health outcomes associated with patterns of substance use disorders among patients with type 2 diabetes and hypertension: Electronic health record findings

AimsTo identify substance use disorder (SUD) patterns and their association with T2DM health outcomes among patients with type 2 diabetes and hypertension. MethodsWe used latent class analysis on electronic health records from the MetroHealth System (Cleveland, Ohio) to obtain the target SUD groups: i) only tobacco (TUD), ii) tobacco and alcohol (TAUD), and iii) tobacco, alcohol, and at least one more substance (PSUD). A matching program with Mahalanobis distance within propensity score calipers created the matched control groups: no SUD (NSUD) for TUD and TUD for the other two SUD groups. The numbers of participants for the target-control groups were 8009 (TUD), 1672 (TAUD), and 642 (PSUD). ResultsTUD was significantly associated with T2DM complications. Compared to TUD, the TAUD group showed a significantly higher likelihood for all-cause mortality (adjusted odds ratio (aOR) = 1.46) but not for any of the T2DM complications. Compared to TUD, the PSUD group experienced a significantly higher risk for cerebrovascular accident (CVA) (aOR = 2.19), diabetic neuropathy (aOR = 1.76), myocardial infarction (MI) (aOR = 1.76), and all-cause mortality (aOR = 1.66). ConclusionsThe findings of increased risk associated with PSUDs may provide insights for better management of patients with T2DM and hypertension co-occurrence.

Patterns of Substance Use Disorders and Associated Co-occurring Psychiatric Morbidity among Patients Seen at the Psychiatric Unit of a Tertiary Health Center.

BackgroundUnderstanding the pattern of co-occurring mental illness in patients with substance use disorders (SUDs) is essential in improving the prevention and treatment of substance use-related problems. This study examined the pattern of SUDs, the associated co-occurring psychiatric morbidities, and associated factors among patients with SUDs managed at a tertiary health center.MethodsThe records of patients who presented with SUDs between 2010 and 2019 were examined. Socio-demographics of interest were extracted from case files. Substance use diagnoses, as well as associated co-occurring mental illness, were extracted and entered into SPSS software. Bivariate analyses including the risk of developing co-occurring mental disorder were calculated.FindingsFor most patients, the initiation of substance use was before the age of 21 years, while the onset of SUDs was between 21-30 years. Cannabis use disorders (CUDs), alcohol use disorders (AUDs), and nicotine use disorders (NUDs) were the commonest SUDs. Compared with those with CUDs, non-users of cannabis were significantly less likely to develop co-occurring mental illness [odds ratio (OR) = 0.25, 95% confidence interval (CI) =0.13-0.42, P = 0.001]. Those with tramadol use disorders (OR = 2.13, 95% CI = 1.03-4.41, P = 0.040) and those without pentazocine use disorders (P = 0.003) were more likely to have a comorbid mental illness. Patients with AUDs (P = 0.001), CUDs (P = 0.001), NUDs (P = 0.001), and tramadol use disorders (P = 0.045) were significantly more likely to be multiple substance users.ConclusionResults suggest an association between SUDs and co-occurring mental illness, though differences in these associations were noticed across the categories of substances. This emphasizes a holistic approach to prevention and care of patients presenting with SUDs.

Substance use disorders in association with attention-deficit/hyperactivity disorder, co-morbid mental disorders, and medication in a nationwide sample

BackgroundThe association of substance use disorders (SUD) with attention-deficit disorder (ADHD), co-morbid mental disorders, and medication has only been studied in isolation and in rather small samples. ProcedureData were based on four Danish national registers covering a total of 20,742 patients with ADHD, their dispensed medications, co-morbid mental disorders, and associated SUD between 1994 and 2010. The analyses considered the risk of various medications (methylphenidate only, antidepressants only, antipsychotic only, mixed medication) in comparison to a control group of non-medicated patients with ADHD, various co-morbid disorders, duration of medication, age at diagnosis, year of birth, and sex for developing SUD. ResultsThe observation period of the cohort ranged between 2.25 and 66.21 years and the prevalence for SUD was 9.51%. The SUD rates were significantly higher prior to, compared to following the onset of medication in the methylphenidate and the mixed medication subgroup, whereas they were significantly higher following onset of medication in the antidepressants and the antipsychotics subgroups. However, the SUD rates were significantly higher in all drug conditions except for methylphenidate after onset of medication compared to the non-medicated subgroup. Risk factors obtained by regression analysis did not include methylphenidate but did include antidepressants, antipsychotics, and mixed medications, in combination with co-morbid mood, anxiety, personality, and conduct disorders, and older age at diagnosis. Longer duration of medication and female sex were protective factors. ConclusionsThis representative study based on a large nationwide psychiatric sample provides solid evidence into the patterns of SUD in patients with ADHD based on medication use and co-morbidities.

A profile of patients with substance use disorders and treatment outcomes: A 10-year retrospective study from the National Rehabilitation Center

Objective The National Rehabilitation Center (NRC) is the major center in the United Arab Emirates (UAE) treating patients with substance use disorders (SUD). The objective of our study is to analyze data from the NRC to examine the trends of SUD in the UAE nationals over the last 10 years and to assess the status of the treatment programme at the NRC. Methods Data was collected during a 10 year period from patients’ records admitted to the NRC (from its inception in 2002 to 2011) to study socio-demographic characteristics, patterns of SUD as well as co-morbid conditions. Results A total of 591 patients were assessed and/or admitted to the NRC during this period. All patients were males between the age group 16 - 66 years, forty two percent were married, 60% were unemployed and 51% were educated below secondary school level. Seventy seven percent of the patients were admitted voluntarily and 23% were involuntarily admitted. Forty one percent was admitted due to alcohol consumption, 20% for prescription drugs and 16% for heroin. Discussion Relapse rate and retention in treatment were used as indicators of the effectiveness of the treatment programmes at the NRC. The number of admissions per patient each year was used as an estimate of relapse which showed a drop from about 60% in the first two years when the NRC opened to about 20% recently. Rates of retention/completion of inpatient treatment and discharge to outpatient care, half-way house or home were about 73% with 27% of patients terminating their treatment earlier. Overall, there has been a steady increase in SUD over the last 10 years with increasing trends of prescription drugs and polysubstance addiction among youth. This necessitates expansion of services to meet the increasing demands as well as increasing efforts towards nationwide effective prevention and public awareness approaches. DOI: http://dx.doi.org/10.4038/ijptsud.v1i1.5912 International Journal of Prevention and Treatment of Substance Use Disorder Vol.1(1) 2013: 62-75

What Characterizes Substance Abusers Who Commit Suicide Attempts? Factors Related to Axis I Disorders and Patterns of Substance Use Disorders

Objective: The frequency of suicide attempts and clinical characteristics of attempters among poly-substance abusers and alcoholics were examined. Methods: A consecutive sample (n = 260) of in- and outpatients from two Norwegian counties were assessed by Composite International Diagnostic Interview (Axis I disorders), Millon’s Clinical Multiaxial Inventory (Axis II disorders) and the Norwegian National Client Assessment Form. When analysing the association between suicide attempters and the range of predictor variables, logistic regression analysis was conducted. Results: Almost half (47%) of the sample reported lifetime suicide attempts; significantly more frequently in poly-substance abusers (58%) than alcoholics (38%). A substance use disorder with duration of ≧15 years and an early onset (<18 years of age) were independently associated with being a suicide attempter after controlling for Axis I disorders. In addition, eating disorders, agoraphobia and major depression were strongly and independently associated with being a suicide attempter. Conclusion: Attempts at preventing suicidal behaviour should not ignore the suicide risk among poly-substance abusers. In addition, prevention of suicidal behaviour demands a treatment programme focusing concomitantly on both addictive behaviour and comorbid psychiatric disorders.

Detecting Serious Mental Illness Among Substance Abusers

Serious mental illnesses (SMIs) commonly co-occur with substance-use disorders and, if undetected and untreated, adversely affect their clinical course. This paper describes the use and scoring of the K6 scale, a brief and valid screening tool for SMI, in a large general population sample derived from the 2001 National Household Survey on Drug Abuse (NHSDA). Analyses examine the demographic characteristics and patterns of substance use disorders among persons with and without a co-occurring SMI.

Ethnie Variation in the Prevalence of Substance Use Disorders in Youth Sectors of Care

Objective: Examine ethnic variation in the prevalence of substance use disorders (SUDs) among adolescents who received services in one or more public sectors of care including: Alcohol and Drug, Juvenile Justice, Mental Health, Public School-based services for youths with serious emotional disturbance, and Child Welfare, in relation to age, gender, and service sector affiliation. Methods: Participants included 936 adolescents 13-18 years of age randomly sampled from all youths who were active in at least one of the above five sectors of care (N = 12,662) in San Diego County, California. SUDs were assessed through structured diagnostic interviews conducted from October 1997 through February 1999. Results: Significant ethnic differences in prevalence rates were found in all sectors except child welfare. African-American youths were significantly less likely than Caucasian youths to meet criteria for lifetime and past-year SUDs. Differential patterns of SUDs were found for ethnic groups relative to Caucasian youths. Conclusions: Substance use disorders are prevalent among youths in all service sectors and there are significant ethnic differences that may represent differential substance use patterns as well as disparities in opportunities for treatment versus more restrictive services. Standardized evidence-based assessment and triage protocols may help in identifying and helping youths with substance use disorders in public service systems.

Psychiatric and medical comorbidities of veterans with substance use disorders.

The authors examined patterns of substance use disorders and psychiatric and medical comorbidity in all male veterans treated in Veterans Affairs (VA) medical centers during a one-year period. A national discharge abstract data base was used to derive point prevalence rates of psychiatric and medical disorders for 539,557 inpatients treated in VA medical centers in fiscal year 1991. Nearly one-quarter of all male veterans treated in the study year had a substance-related diagnosis. The most prevalent substance use disorders were alcohol dependence (87.7 percent) and cocaine dependence (17.5 percent), and the most frequent psychiatric diagnoses among veterans with substance-related diagnoses were depression and personality disorders. Digestive disorders were more prevalent among veterans who abused substances than among veterans who did not, and veterans who abused substances were also more likely to have multiple hospitalizations and longer index hospital stays. Substance use disorders and comorbid psychiatric syndromes are common in male veterans treated in VA hospitals. Veterans with substance-related diagnoses may have longer hospital stays and more frequent hospitalizations than veterans without substance use disorders.