• Family practice · Mar 2022

    Substance use disorders among primary care patients screening positive for unhealthy alcohol use.

    • Verena E Metz, Vanessa A Palzes, Andrea Hessel Kline-Simon, Felicia W Chi, Cynthia I Campbell, Constance M Weisner, and Stacy A Sterling.
    • Center for Addiction and Mental Health Research, Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA.
    • Fam Pract. 2022 Mar 24; 39 (2): 226233226-233.

    BackgroundDespite high prevalence of polysubstance use, recent data on concurrent alcohol use in patients with specific substance use disorders (SUDs) are lacking.ObjectiveTo examine associations between specific SUDs and alcohol consumption levels.MethodsUsing electronic health record data, we conducted a cross-sectional study of 2,720,231 primary care adults screened for alcohol use between 2014 and 2017 at Kaiser Permanente Northern California. Alcohol consumption levels were categorized as no reported use, low-risk use, and unhealthy use (exceeding daily, weekly, or both recommended drinking limits). Using multinomial logistic regression, and adjusting for sociodemographic and health characteristics, we examined the odds of reporting each alcohol consumption level in patients with a prior-year SUD diagnosis (alcohol, cannabis, cocaine, inhalant, opioid, sedative/anxiolytic, stimulant, other drug, nicotine, any SUD except nicotine) compared to those without.ResultsThe sample was 52.9% female, 48.1% White; the mean age was 46 years (SD = 18). Patients with SUDs were less likely to report low-risk alcohol use relative to no use compared with patients without SUDs. Patients with alcohol or nicotine use disorder had higher odds of reporting unhealthy alcohol use relative to no use; however, patients with all other SUDs (except cocaine) had lower odds. Among patients who reported any alcohol use (n = 861,427), patients with SUDs (except opioid) had higher odds of exceeding recommended limits than those without.ConclusionThe associations of unhealthy alcohol use and SUDs suggest that screening for both alcohol and drug use in primary care presents a crucial opportunity to prevent and treat SUDs early.© The Author(s) 2021. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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