Epidemiology of Substance Use Disorders

Author(s):  
Denise B. Kandel ◽  
Mei-Chen Hu ◽  
Pamela C. Griesler

This chapter reviews the epidemiology of substance use, abuse and dependence on alcohol, nicotine and illicit drugs in the population among adults and adolescents; comorbidity with psychiatric disorders; the importance of early onset; and animal models of the Gateway Hypothesis. Existing epidemiological studies and reports have many limitations, necessitating extensive secondary analysis of the data sets to overcome some of those limitations. Nicotine is the most addictive of the drugs and the most chronic addiction. It is the one substance for which dependence is higher among women than men. Adolescence is a period of increased risk for drug abuse and dependence among last year users. Psychiatric comorbidity with substance use disorders is high, especially for antisocial personality disorder. Animal models of the Gateway Hypothesis have uncovered basic mechanisms of nicotine action in the brain.

Author(s):  
G Vallecillo ◽  
R Perelló ◽  
R Güerri ◽  
F Fonseca ◽  
M Torrens

Abstract Background People with substance use disorders are considered at increased risk of COVID-19 and its more serious complications, however data on the impact of COVID-19 are lacking. The study aimed to describe the clinical characteristics and outcomes of COVID-19 on people with substance use disorders. Methods an observational study was carried out including patients aged ≥ years with COVID-19 pneumonia admitted to an urban hospital during March 12 to June 21,2020. Results Among 2078 patients admitted, 27 (1.3%) were people with substance use disorders: 23(85.2%) were men with a median age of 56.1 + 10.3 years and. The main SUD were alcohol in 18(66.7%) patients, heroine in 6(22.2%) and cocaine in 3(11.1%) and 24(88.8%) patients were on ongoing substance use disorder treatment. One or more comorbidities associated to COVID-19 risk were observed in 18(66.6%) of patients. During a median length of stay of 10 days (IQR:7-19), severe pneumonia developed in 7(25.9%) patients, acute respiratory distress syndrome in 5 (18.5%) and none died. Conclusion Larger sample sizes and sero-epidemiological studies are needed to confirm the low incidence of severe COVID-19 on patients with SUD.


2012 ◽  
Vol 43 (9) ◽  
pp. 1869-1880 ◽  
Author(s):  
V. A. Morgan ◽  
F. Morgan ◽  
G. Valuri ◽  
A. Ferrante ◽  
D. Castle ◽  
...  

BackgroundLarge epidemiological studies are needed to better understand the prevalence and profile of offending by people with mental illness. This study used a whole-of-population design to examine the prevalence, type and pattern of offending across all psychiatric diagnoses, including schizophrenia, compared to the general population.MethodWe used whole-of-population longitudinal record-linked data for a cohort of all Western Australians born 1955–1969 to determine arrest history over the period 1985–1996 and to ascertain recorded history of psychiatric illness. Of the cohort, 116 656 had been arrested and 40 478 were on the psychiatric case register.ResultsThe period prevalence of arrest for people with any psychiatric illness was 32.1%. The highest arrest prevalence, by diagnostic category, was for substance use disorders (59.4%); the prevalence for schizophrenia was 38.7%. Co-morbid substance use disorders significantly increased risk of arrest in people with schizophrenia. The prevalence of mental illness among offenders was 11.1%: 6.5% of offenders had substance use disorders and 1.7% had schizophrenia. For the majority of offenders with a psychiatric illness, first arrest preceded first contact with mental health services; for schizophrenia only, this proportion was increasing over time. The mean percentage annual change in the number of arrests during 1985–1996 rose significantly for offenders with a psychiatric illness other than schizophrenia and dropped significantly for those with no mental illness. Compared to non-psychiatric offenders, offenders with schizophrenia were more likely to offend alone, to offend in open places and to target strangers.ConclusionsOur findings open the way to an informed approach to the management of offenders with mental illness.


2017 ◽  
Vol 77 ◽  
pp. 209-218 ◽  
Author(s):  
Steven F. Merkel ◽  
Lee Anne Cannella ◽  
Roshanak Razmpour ◽  
Evan Lutton ◽  
Ramesh Raghupathi ◽  
...  

Author(s):  
Sarah C Snow ◽  
Gregg C Fonarow ◽  
Joseph A Ladapo ◽  
Donna L Washington ◽  
Katherine Hoggatt ◽  
...  

Background: Several cardiotoxic substances contribute to the development of heart failure (HF). The burden of comorbid substance use disorders (SUD) among patients with HF is under-characterized. Objectives: To describe the national burden of comorbid SUD (tobacco, alcohol, or drug use disorders) among hospitalized HF patients in the U.S. Methods: We used data from the 2014 National Inpatient Sample to calculate the proportion of hospitalizations for a primary HF admission with tobacco, alcohol, or drug use disorder diagnoses, accounting for demographic factors. Drug use disorder analysis was further sub-divided into specific illicit substance categories. Results: There were a total of 989,080 HF hospitalizations of which 35.3% (n=348,995) had a documented SUD. Tobacco use disorder (TUD) was most common (n= 327,220, 33.1%) followed by drug use disorder (DUD) (n=34,600, 3.5%) and alcohol use disorder (AUD) (n=34,285, 3.5%). Female sex was associated with less TUD (OR 0.59; 95% CI, 0.58-0.60), AUD (OR 0.23; 95% CI, 0.22-0.25) or DUD (OR 0.58; 95% CI 0.55-0.62). Tobacco, alcohol, cocaine, and opioid use disorders were highest among HF patients age 45 to 55, while cannabis and amphetamine use was highest in those <45 years. Native American race (versus White) was associated with increased risk of AUD (OR 1.67; 95% CI 1.27-2.20). Black race was associated with increased risk of AUD (OR 1.09; 95% CI 1.02-1.16) or DUD (OR 1.63; 95% CI 1.53-1.74). Medicaid insurance (versus Medicare) was associated with greater TUD (OR 1.27; 95% CI 1.23-1.32), AUD (OR 1.74; 95% CI 1.62-1.87), and DUD (OR 2.15; 95% CI 2.01-2.30). Decreasing quartiles of median household income were associated with increasing SUD. Conclusions: Comorbid SUD disproportionately affects certain HF populations, including men, younger age groups, lower SES patients, and race/ethnic minorities. Further research on interventions to improve prevention and treatment of SUD among hospitalized HF patients are needed given the high rates of SUD in this population. Systematically screening hospitalized HF patients for SUD may reveal opportunities for treatment and secondary prevention.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Peter B. Barr ◽  
Albert Ksinan ◽  
Jinni Su ◽  
Emma C. Johnson ◽  
Jacquelyn L. Meyers ◽  
...  

2020 ◽  
Author(s):  
Ludwig Kraus ◽  
Alfred Uhl ◽  
Josefine Atzendorf ◽  
Nicki-Nils Seitz

Abstract Background Parental substance misuse is reported to endanger the health and psychological development of children and adolescents. The aim of the present study was to estimate the number of children currently affected by substance use disorders (SUDs) of any adult living in the same household. Methods Data came from the 2018 German Epidemiological Survey of Substance Abuse (ESA) among 18-64-year-olds (n = 9,267) and from population statistics. DSM-IV diagnostic criteria were used to assess SUD (abuse or dependence) related to tobacco, alcohol, cannabis, cocaine or amphetamine. Based on the number of household members, the number of children below the age 18 years and the information on SUD status of the respondent living in this household, the number of children in households with at least one member with SUD was estimated. Results In 2018, there were 13,597,428 children younger than 18 years living in Germany. Of these, 5.2–7.9% (686,482–696,279) were estimated to live in households where at least one adult had an alcohol-related disorder, 5.0–7.4% (674,065–690,792) in households where at least one adult was tobacco dependent and 0.38–1.05% (93,229–142,141) in households where at least one adult had a disorder related to the use of illicit drugs. The total number of children in close contact with SUD adults was estimated at 7.4–11.2% (1,000,725–1,522,667). Conclusions The large number of children affected by adults with SUD has implications for identification and prevention. Substantial variation in estimates, resulting from differences in methods, definition of exposure and exposure to whom, calls for international standardization in order to make estimates comparable.


2018 ◽  
Vol 35 (4) ◽  
pp. 220-225 ◽  
Author(s):  
Karen Urbanoski ◽  
Joyce Cheng ◽  
Jürgen Rehm ◽  
Paul Kurdyak

ObjectivesWe described the population of people who frequently use ED for mental disorders, delineating differences by the number of visits for substance use disorders (SUDs), and predicted the receipt of follow-up services and 2-year mortality by the level of ED use for SUD.MethodsThis retrospective observational study included all Ontario residents 15 years and older who had five or more ED visits during any 12-month period from 2010 to 2012 (n=263 346). The study involved a secondary analysis of administrative health databases capturing emergency, hospital and ambulatory care. Frequent ED users for mental disorders (n=5416) were grouped into nested categories based on the number of ED visits for SUD. Logistic regression was used to examine group differences in the receipt of follow-up services and mortality, controlling for sociodemographics, comorbidities and past service use.ResultsThe majority of frequent ED users for mental disorders had at least one ED visit for SUD, most commonly involving alcohol. Relative to people with no visits for SUD, those with ED visits for SUD were older and more likely to be men (Ps <0.001). As the number of ED visits for SUD increased, the likelihood of receiving follow-up care, particularly specialist mental healthcare, declined while 2-year mortality steadily increased (Ps <0.001). These associations remained after controlling for comorbidities and past service use.ConclusionsFindings highlight disparities in the receipt of specialist care based on use of ED services for SUD, coupled with a greater mortality risk. There is a need for policies and procedures to help address unmet needs for care and to connect members of this vulnerable subgroup with services that are better able to support recovery and improve survival.


Author(s):  
Kristina Caudle ◽  
B.J. Casey

Drug and alcohol dependence affects millions each year. Adolescence is a period of increased risk for substance use disorders. Understanding how the brain is changing during this developmental window relative to childhood and adulthood and how these changes vary across individuals is critical for predicting risk of later substance abuse and dependence. This chapter provides an overview of recent human imaging and animal studies of brain development focusing on changes in corticostriatal circuitry that has been implicated in addiction. Behavioral, clinical, and neurobiological evidence is provided to help elucidate who may be most at risk for developing a substance abuse problem and whenthey may be most vulnerable.


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