scholarly journals Healthcare cost associations of patients who use illicit drugs in Florida: a retrospective analysis

Author(s):  
Jessica L. Ryan ◽  
Veronica R. Rosa

Abstract Background Illicit drug use increases visits to the hospital. Research is limited on the costs of these healthcare visits by illicit drug. Methods Florida’s Agency for Health Care Administration’s emergency department and inpatient datasets from 2016 to 2018 were analyzed. Adults who used an illicit drug were included in the study population resulting in 709,658 observations. Cost-to-charge ratios were used to estimate healthcare costs. Linear regression analyzed associations of illicit drugs with total healthcare cost. Results Total healthcare costs are estimated at $6.4 billion over the 3 year period. Medicare paid for the most patient care ($2.16 billion) with Medicaid and commercial insurance each estimated at $1.36 billion. Cocaine (9.25%) and multiple drug use (6.12%) increased the costs of an ED visit compared to a patient with cannabis SUD. Opioids (23.40%) and inhalants use (16.30%) increased the costs of inpatient compared to cannabis SUD. Conclusion Healthcare costs are high of patients with illicit drug SUD and poisoning, over half of which are paid for with tax payer dollars and to an unknown degree hospital write-offs. Injuries and illness of patients using cocaine and multiple drugs are associated with more expensive ED patient care and opioids and inhalants are associated with more expensive inpatient care.

2020 ◽  
Vol 3 (2) ◽  
pp. 15-29
Author(s):  
Sogo Angel Olofinbiyi ◽  
Thembelihle Mtambo

South African societies have been characterized by the prolific incidence of illicit drug use in recent times.  The paper attempts to examine the legislations implemented on the use of illicit drugs in South Africa. The study adopts a review of the literature to identify and describe the most common illicit drugs used around South Africa communities, placing emphasis on the policies developed by the South African government in combating these situations. The research follows a critical   discussion on the issues associated with drug use, its causes, as well as its effects on humans and the environment. The study recommends relevant initiatives to combat all intricacies associated with drug use within the country. This approach will be appropriate in facilitating a clear-cut   understanding of the possible remedies to quench the burning flame of illicit drug use across a broad range of South African communities.


Perfusion ◽  
2021 ◽  
pp. 026765912110281
Author(s):  
Chrissa Sioka ◽  
Georgios Georgiou ◽  
Christos Katsouras ◽  
Konstantinos Pappas ◽  
Dimitris-Nikiforos Kiortsis ◽  
...  

Patients with illicit drug use may have deleterious acute and chronic cardiac effects. We present a case of a 42-year-old man, former alcohol and various illicit drugs user, who was admitted to the psychiatric unit for management of psychosis. Because of his previous drug and alcohol history, a cardiological evaluation was performed which revealed silent severe myocardial ischemia detected by myocardial perfusion imaging (MPI). The myocardial ischemia was attributed to coronary microvascular dysfunction, occurring several years after quitting the illicit drugs. This study highlights the potential myocardial ischemia that may occur in patients with previous alcohol and illicit drug use, and the role of MPI, a non-invasive test that can provide important information regarding the myocardial status of such patients, even without obvious cardiac symptoms or findings.


2018 ◽  
Vol 64 (2) ◽  
pp. 114-118
Author(s):  
Rafael Alves Guimarães ◽  
Márcia Maria de Souza ◽  
Karlla Antonieta Amorim Caetano ◽  
Sheila Araujo Teles ◽  
Marcos André de Matos

Summary Objective: To estimate the prevalence and factors associated with illicit drug use by adolescents and young adults of a formal urban settlement. Method: Cross-sectional study including adolescents and young adults 12-24 years of an urban settlement in the Midwest Region of Brazil. Data were collected using a structured questionnaire and analyzed using Stata, version 12.0. We used Poisson regression model to estimate the factors associated with illicit drug use. Results: Of the total participants (n=105), 27.6% (95CI 20.0-36.9%) had used illicit drugs such as marijuana, cocaine, crack, LSD and inhalants. The consumption of these substances was associated with male gender, use of body piercing and/or tattoos, licit drug use and self-report of signs and/or symptoms of sexually transmitted infections. Conclusion: High prevalence of illicit drug use was found in the individuals investigated, ratifying the presence of risk factors to the vulnerability of the settlers to use these substances in the urban settlement population.


2012 ◽  
Vol 15 (5) ◽  
pp. 631-641 ◽  
Author(s):  
Michael T. Lynskey ◽  
Arpana Agrawal ◽  
Anjali Henders ◽  
Elliot C. Nelson ◽  
Pamela A. F. Madden ◽  
...  

Cannabis is the most widely used illicit drug throughout the developed world and there is consistent evidence of heritable influences on multiple stages of cannabis involvement including initiation of use and abuse/dependence. In this paper, we describe the methodology and preliminary results of a large-scale interview study of 3,824 young adult twins (born 1972–1979) and their siblings. Cannabis use was common with 75.2% of males and 64.7% of females reporting some lifetime use of cannabis while 24.5% of males and 11.8% of females reported meeting criteria for DSM-IV cannabis abuse or dependence. Rates of other drug use disorders and common psychiatric conditions were highly correlated with extent of cannabis involvement and there was consistent evidence of heritable influences across a range of cannabis phenotypes including early (≤15 years) opportunity to use (h2 = 72%), early (≤16 years) onset use (h2 = 80%), using cannabis 11+ times lifetime (h2 = 76%), and DSM abuse/dependence (h2 = 72%). Early age of onset of cannabis use was strongly associated with increased rates of subsequent use of other illicit drugs and with illicit drug abuse/dependence; further analyses indicating that some component of this association may have been mediated by increasing exposure to and opportunity to use other illicit drugs.


2019 ◽  
Vol 68 (1) ◽  
pp. 8-15
Author(s):  
Lauro Miranda Demenech ◽  
Samuel C. Dumith ◽  
Luiza Santos Ferreira ◽  
Mariana Lima Corrêa ◽  
Pedro San Martin Soares ◽  
...  

ABSTRACT Objective: To measure the prevalence of illicit drugs use in the lifetime, last year and last month, as well as the factors associated to the last year's use and its association with academic migration, among undergraduate students of a university in southern Brazil. Methods: In this cross-sectional study, data were collected through self-administered questionnaire. It was conducted a clustered systematic sampling. For multivariate analyses, it was used Poisson regression. Results: 1,423 students participated. The prevalence of illicit drug use in the lifetime, last year and last month were 42.4%, 25.5% and 17.7%, respectively. Regarding illicit substances, marijuana use was the most prevalent. The variables independently associated with illicit drugs use in the last year were academic migration, being male, younger, single, high parent's educational level, living with peers, tobacco use in the last year, and having friend and relative that have used illicit drugs. Religious practice had a protective effect. Conclusion: Individuals who migrated from their cities to study at the university are more exposed to the main risk factors pointed out by this research and hence to the use of illicit drugs. Based on these results, we suggest that universities develop evaluation, prevention, treatment or referral strategies considering specific needs of this population


Author(s):  
Monica O. Kuteesa ◽  
Helen A. Weiss ◽  
Sarah Cook ◽  
Janet Seeley ◽  
Josephine N. Ssentongo ◽  
...  

Background: We determined the prevalence of and risk factors for alcohol misuse and illicit drug use among young Ugandans in fishing communities, a recognised “key population” for human immunodeficiency virus (HIV) infection. Methods: We conducted a cross-sectional survey among young people (15–24 years) in fishing communities in Koome, Uganda, in December 2017–July 2018. Using Audio-Assisted Self-Interviewing, we collected data on socio-demographic characteristics and alcohol use, including the Alcohol Use Disorders Identification Test (AUDIT) and timeline follow-back calendar (TLFB). Blood samples were analysed for HIV, herpes simplex virus 2 (HSV2), and Phosphatidyl ethanol (PEth 16:0/18:1). Urine samples were analysed for illicit drugs. Results: Among 1281 participants (52.7% male, mean age 20 years), 659 (51.4%) reported ever drinking alcohol, 248 (19.4%) had 12-month-AUDIT ≥ 8, and 261 (20.5%) had whole-blood PEth 16:0/18:1 concentration ≥ 20 ng/mL, indicating significant consumption. In multivariable analyses, PEth 16:0/18:1 ≥ 20ng/mL, AUDIT ≥ 8 and binge drinking (≥6 standard drinks per drinking occasion in the previous month from TLFB) were all strongly associated with older age, low education, smoking, and HSV2. Illicit drug use prevalence was 5.2% and was associated with older age, low education, being single, and smoking. Conclusion: Levels of alcohol misuse were high among young people in fishing communities and associated with HSV2, a proxy for risky sexual behaviour. Alcohol and illicit drug harm reduction services and HIV prevention programs in Uganda should prioritise young fisherfolk.


2020 ◽  
Vol 7 (3) ◽  
Author(s):  
Ellen F Eaton ◽  
Andrew O Westfall ◽  
Brandi McClesky ◽  
Cayce S Paddock ◽  
Peter S Lane ◽  
...  

Abstract Background Hospitalized persons who inject drugs are at a greater risk of adverse hospital outcomes including discharge against medical advice, inpatient illicit drug use, overdose, and death. However, there are limited data on the frequency and outcomes of these events in the United States. Methods This retrospective analysis included patients with injection-related infections receiving a protocol for injection drug use (IDU) at University of Alabama at Birmingham Hospital from 2016 to 2017. In-hospital IDU was suspected or reported drug usage plus confirmatory drug screen, and documented discharges “against medical advice” were deemed patient-directed discharges (PDD). We analyzed the frequency of and associations between in-hospital IDU, PDD, 30-day readmission, and deaths (between 2016 and 2019) using McNemar’s tests. Logistic regression models evaluated the association between PDD, in-hospital IDU, readmission, and death. Results Overall, 83 patients met inclusion criteria: 28 (34%) with in-hospital IDU, 12 (14%) PDD, 9 (11%) died, and 12 (14%) 30-day readmission. In-hospital IDU was significantly associated with PDD (P = .003), 30-day readmission (P = .005), and death (P = .0003). Patient-directed discharges and 30-day readmission were not significantly associated with death nor with each other. Conclusions In a cohort of patients receiving inpatient care for injection-related infections, illicit drug use, PDD, 30-day readmissions, and death were common. Furthermore, patients who use illicit drugs while hospitalized are significantly more likely to leave early, be readmitted, and/or die. We must design models of care that prevent adverse outcomes, including drug use and PDD, to reduce barriers to evidence-based treatment of infections.


2015 ◽  
Vol 28 (4) ◽  
pp. 577-589 ◽  
Author(s):  
Namkee G. Choi ◽  
Diana M. DiNitto ◽  
C. Nathan Marti ◽  
Bryan Y. Choi

ABSTRACTBackground:Despite growing numbers of older-adult illicit drug users, research on this topic is rare. This study examined the relationship between marijuana and/or other illicit drug use and major depressive episode (MDE) and serious suicidal thoughts among those aged 50+ years in the USA.Methods:The public use files of the 2008 to 2012 US National Survey on Drug Use and Health (NSDUH) provided data on 29,634 individuals aged 50+ years. Logistic regression analysis was used to test hypothesized associations between past-year marijuana and/or other illicit drug use and MDE and serious suicidal thoughts.Results:Nearly 6% of the 50+ years age group reported past-year marijuana and/or other illicit drug use. Compared to non-users of any illicit drug, the odds of past-year MDE among those who used marijuana only, other illicit drugs only, and marijuana and other illicit drugs were 1.54 (95% CI = 1.17–2.03), 2.75 (95% CI = 1.75–4.33), and 2.12 (95% CI = 1.45–3.09), respectively. Those who used marijuana and other drugs also had higher odds (2.44, 95% CI = 1.58–3.77) of suicidal thoughts than non-users of any illicit drug. However, among users of any illicit drug, no difference was found among users of marijuana only, marijuana and other illicit drugs, and other illicit drugs only. Among marijuana users, marijuana use frequency was a significant correlate of suicidal thoughts only among those with MDE.Conclusions:Health and mental health (MH) service providers should pay close attention to the potential reciprocal effects of marijuana and other illicit drug use and MDE and suicidal thoughts among late middle-aged and older adults.


Author(s):  
Chloé Carpentier ◽  
Luis Royuela ◽  
Linda Montanari ◽  
Philip Davis

This chapter provides an overview of drug use in prison. It is centered on illicit drug use in Europe, where the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) has been collecting aggregated data from various sources for 15 years. It also reviews, based on published literature, data from the four other global regions. A total of 59 studies from 31 countries in the five world regions were included for analysis. Results show that the prevalence of drug use varies greatly between studies. Lifetime prevalence of any illicit drug use in prison ranges between 2% to 76% worldwide with, in most cases, cannabis being the most frequently reported substance. More recent (past-month) illicit drug use is reported by <1% to 65% of inmates, while <1% to 39% report injecting illicit drugs during their stay in prison. Alcohol use in prison is reported in a few studies only, varying between 2% to 77% while the prevalence of current tobacco smoking ranges between 4% to 90%. In general, available data are scarce and patchy, especially outside Europe, with large variations in methodology relating to sampling strategy and measurement. This heterogeneity hampers comparison and may, in part, account for the wide range of prevalence estimates. Comparable methods and measures of drug use and its consequences in prison populations are needed to facilitate international comparisons and provide the sound information needed for development and implementation of drug interventions in various prison settings across the globe.


2016 ◽  
Vol 31 (1) ◽  
pp. 35-42 ◽  
Author(s):  
Judy C. Chang ◽  
Cynthia L. Holland ◽  
Jill A. Tarr ◽  
Doris Rubio ◽  
Keri L. Rodriguez ◽  
...  

Purpose. To assess use, screening, and disclosure of perinatal marijuana and other illicit drugs during first obstetric visits. Design. Observational study that qualitatively assesses provider screening and patient disclosure of substance use. Setting. Study sites were five urban outpatient prenatal clinics and practices located in Pittsburgh, Pennsylvania. Participants. Pregnant patients and obstetric providers were recruited as participants. Methods. We audio recorded patient-provider conversations during first obstetric visits and obtained patient urine samples for drug analyses. Audio recordings were reviewed for provider screening and patient disclosure of illicit drug use. Urine analyses were compared with audio recordings to determine disclosure. Results. Four hundred and twenty-two pregnant patients provided complete audio recordings and urine samples for analyses. Providers asked about illicit drug use in 81% of the visits. One hundred twenty-three patients (29%) disclosed any current or past illicit drug use; 48 patients (11%) disclosed current use of marijuana while pregnant. One hundred and forty-five samples (34%) tested positive for one or more substances; marijuana was most commonly detected (N = 114, 27%). Of patients who tested positive for any substance, 66 (46%) did not disclose any use; only 36% of patients who tested positive for marijuana disclosed current use. Conclusion. Although marijuana is illegal in Pennsylvania, a high proportion of pregnant patients used marijuana, with many not disclosing use to their obstetric care providers.


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