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Research Summary

Co-Occurring Conditions in Insured People With Alcohol and Other Drug Problems

Prior research on the prevalence of medical and psychiatric conditions in patients receiving treatment for alcohol and other drug problems has focused on inpatients and patients in publicly-funded programs. Much less is known about the prevalence of such problems in insured outpatients receiving treatment through managed care programs.

Using patient questionnaires and clinical records, this study compared the 12-month prevalence of medical and psychiatric conditions among 747 patients entering alcohol and/or drug treatment, and age- and sex-matched controls from the same large group-model health maintenance organization. Patients were young (mean age of 38), and 59% had alcohol dependence.

Compared with controls, patients with alcohol and/or other drug problems had a higher prevalence of the following (among others):

depression (29% versus 3%)
headache (9% versus 4%)
anxiety (17% versus 2%)
asthma (7% versus 3%)
injury/overdoses (26% versus 12%)
hypertension (7% versus 3%)
major psychoses (7% versus 0.4%)
acid-related disorder (5% versus 2%)
lower back pain (11% versus 6%)
arthritis (4% versus 1%)

Findings were similar among patients with alcohol dependence. Patients with alcohol dependence were also more likely than controls to have liver cirrhosis (1% versus 0.1%).


In private managed care settings (as in other settings), common medical conditions are more prevalent among patients with alcohol and other drug problems. These findings support the practice of screening for substance abuse problems in medical clinics and for medical problems in substance abuse treatment programs. Private and managed-care substance abuse treatment programs should follow the lead of many publicly-funded treatment programs and address linkages to primary care services.

Kevin L. Kraemer, MD, MSc


Mertens JR, Lu YW, Parthasarathy S, et al. Medical and psychiatric conditions of alcohol and drug treatment patients in an HMO. Arch Intern Med. 2003;163:2511–2517.
(view abstract)