DSM-5 substance use disorders among adult primary care patients: Results from a multisite study.
2017 10 01
Journal Article
Authors:
Wu, L.T.;
McNeely, J.;
Subramaniam, G.A.;
Brady, K.T.;
Sharma, G.;
VanVeldhuisen, P.;
Zhu, H.;
Schwartz, R.P.
Secondary:
Drug Alcohol Depend
Volume:
179
Pagination:
42-46
PMID:
28753480
DOI:
10.1016/j.drugalcdep.2017.05.048
Keywords:
Adult; Alcoholism; Cannabis; Diagnostic and Statistical Manual of Mental Disorders; Heroin; Humans; Hypnotics and Sedatives; Illicit Drugs; Opioid-Related Disorders; Prevalence; Primary Health Care; Substance-Related Disorders; Tobacco Use Disorder
Abstract:
BACKGROUND: There are limited data about the extent of DSM-5 substance use disorders (SUDs) among primary care patients.METHODS: This study analyzed data from a multisite validation study of a substance use screening instrument conducted in a diverse sample of 2000 adults aged ≥18 years recruited from five primary care practices in four states. Prevalence and correlates of 12-month DSM-5 SUDs were examined.RESULTS: Overall, 75.5% of the sample used any substance, including alcohol (62.0%), tobacco (44.1%), or illicit drugs/nonmedical medications (27.9%) in the past 12 months (marijuana 20.8%, cocaine 7.3%, opioids 4.8%, sedatives 4.1%, heroin 3.9%). The prevalence of any 12-month SUD was 36.0% (mild disorder 14.2%, moderate/severe disorder 21.8%): tobacco 25.3% (mild 11.5%, moderate/severe 13.8%); alcohol 13.9% (mild 6.9%, moderate/severe 7.0%); and any illicit/nonmedical drug 14.0% (mild 4.0%, moderate/severe 10.0%). Among past 12-month users, a high proportion of tobacco or drug users met criteria for a disorder: tobacco use disorder 57.4% (26.1% mild, 31.3% moderate/severe) and any drug use disorder 50.2% (14.3% mild, 35.8% moderate/severe); a lower proportion of alcohol users (22.4%) met criteria for alcohol use disorder (11.1% mild, 11.3% moderate/severe). Over 80% of adults with opioid/heroin use disorder met criteria for a moderate/severe disorder. Younger ages, male sex, and low education were associated with increased odds of having SUD.CONCLUSION: These findings reveal the high prevalence of SUDs in primary care and underscore the need to identify and address them.
