Heavy Drinking Is Common and Problematic in Primary Care Patients with Drug Use
The prevalence and adverse consequences of unhealthy alcohol use in primary care patients who screen positive for drug use are unclear. Researchers conducted a secondary analysis of 589 primary care patients with drug use who participated in a randomized trial of brief intervention for drug use and completed assessments at baseline and 6 months. For this analysis, the main independent variable was baseline heavy drinking, assessed with the question “In the past month, how many times have you had X or more drinks in a day?” (X=4 for women, 5 for men).
- The main drugs of choice were marijuana (64%), cocaine (18%), and opioids (16%). At baseline, 48% of participants reported ≥1 heavy drinking day (25% with 1–4 heavy drinking days, 23% with >4 heavy drinking days) in the past month.
- In adjusted analyses, any heavy drinking at baseline was significantly associated with:
- At baseline: DSM-IV drug dependence (odds ratio [OR], 1.74), use of >1 drug (OR, 1.64), drug problems (OR, 1.46), any unsafe sex (OR, 1.90), and occurrences of unsafe sex (incidence rate ratio [IRR], 1.87).
- At 6 months: Number of days in past month using the main drug (IRR, 0.75), DSM-IV drug dependence (OR, 1.77), use of >1 drug (OR, 1.73), any unsafe sex (OR, 1.90), and any arrest or incarceration (OR, 2.01).
Comments:
This secondary analysis indicates a high prevalence of heavy drinking and adverse consequences in primary care patients with drug use at a single urban site. Although prevalence and associations could potentially differ with other clinical populations, the study’s findings certainly suggest that clinicians should carefully screen for unhealthy alcohol use in their primary care patients who have drug use.
Kevin L. Kraemer, MD, MSc
Reference:
Maynié-François C, Cheng DM, Samet JH, et al. Unhealthy alcohol use in primary care patients who screen positive for drug use. Subst Abus. 2016 [Epub ahead of print]. doi: 10.1080/08897077.2016.1216920.