Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #114167

Ian RH Rockett, PhD, MPH, Injury Control Research Center, West Virginia University School of Medicine, PO Box 9190, Morgantown, WV 26506-9190, Sandra L. Putnam, PhD, Population Health Research Center, Pacific Institute for Research and Evaluation (PIRE), 1541 Stewartstown Rd., Morgantown, WV 26505, 3042925148, sputnam@pire.org, Haomiao Jia, PhD, Department of Community Medicine, Mercer University School of Medicine, 1550 College Street, Macon, GA 31207, and Gordon S. Smith, MD, MPH, Liberty Mutual Research Institute for Safety, 71 Frankland Rd, Hopkinton, MA 01748.

Targeting adult ED patients, study objectives were to (1) estimate the prevalence of self-reported use of illicit and licit substances and prescription drug abuse, (2) correct substance use estimates for underreporting, and (3) predict undeclared substance use. Data derive from a cross-sectional, statewide, 2-stage probability sample survey, conducted in 7 Tennessee general hospital EDs, between 6/96 and 1/97. Rapid assay saliva alcohol and urine drug screening augmented personal interviews. The highest prevalence of declared current or 30-day use was 34% for alcohol, 13% for Schedule IV painkillers, 95 for tranquilizers, and 8% for marijuana. Among the 5% of patients reporting prescription drug abuse, 66% abused stimulants, 16% tranquilizers, 14% sedatives, 9% Schedule II opioids, and 6% Schedule IV painkillers. Thirty-eight percent of this group reported polydrug abuse. Current overall substance use rose from 44% to 56% for female ED patients and from 61% to 69% for male patients, after correction for underreporting based on toxicologic screening results. The biggest changes involved opioids, tranquilizers, stimulants, and marijuana. Logistic regression analysis showed that excess undeclared substance use was strongly associated with patients being 65 years and older, and with having no history of substance abuse treatment. While elderly patients declared less substance use than other ED patients, their higher refusal rate for saliva alcohol screening and heavier prescription drug use, make them an important group to assess for substance use, abuse, and dependence, and for brief interventions and referral to treatment where indicated.

Learning Objectives:

(
• Identify the prevalence of substance use and abuse by type of drug overall and by gender before and after correction for under-reporting. (
• Understand the importance of correcting for undeclared use/under-reporting of substance use using the results of toxicologic screening. (
• Describe predictors of excess undeclared substance use and document increases in the prevalence of substance use with correction.

Keywords: Screening, Substance Abuse Assessment

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.