The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #65246

Jennifer Mertens, MA¹, Constance Weisner, DrPH, MSW², and G. Thomas Ray¹. (1) Kaiser Permanente Division of Research, 2000 Broadway, Oakland, CA 94612-2304, 510-891-3570, jrm@dor.kaiser.org, (2) Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave., San Francisco, CA 94143

Background: Substantial evidence exists that individuals with substance abuse or dependence disorders have heightened comorbidities and health care costs. However, little is known about the comorbidities and costs of the less severe, but larger population of "hazardous" drinkers and drug users. Methods: A systematic sample of 1419 patients from HMO primary care clinics was screened for hazardous drinking and drug use. Health plan databases were used to examine medical conditions and health care costs of hazardous drinkers and drug users in the year prior to screening, in comparison to 16,152 patients who did not fall into the sample, (with age and gender adjustments). Results: We found a prevalence of 7.5% for hazardous drinking and 3.2% for hazardous drug use in primary care (10% had at least one of the two problems). Hazardous drinkers and drug users had heightened prevalence of eight medical conditions, including such costly conditions as injury and hypertension. In general, health care costs were not higher, except for primary care costs, and among those with psychiatric symptoms. Conclusions: The relatively high prevalence of hazardous drinking and drug use, combined with the heightened risk of several medical conditions for these individuals provides support for the benefits of screening and intervention in medical settings. Future research should follow the utilization and costs of hazardous drinkers and drug users over long follow-ups to examine if they are delaying seeking treatment for medical conditions.

Learning Objectives:

• Describe the prevalence of hazardous drinking and drug use in private primary care settings.
• List three medical conditions that are heightened in hazardous drinkers and drug users in primary care settings.
• Recognize the potential benefit of screening for hazardous drinking and drug use in medical settings.

Keywords: Alcohol Use, Primary Care

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.