Clinical Needs of Patients With Problem Drug Use
Clinical Needs of Patients With Problem Drug Use
The purpose of this study was to examine baseline characteristics of people across the range of problem drug use to identify their clinical needs. Results confirmed that, as a group, patients with problem drug use had an unusually high number of co-occurring medical conditions, many serious and chronic, suggesting they are likely to need ongoing medical care. Results also indicated that patients with the highest drug use severity were unusual in the frequency and degree of psychiatric and substance abuse problems they present; their unstable lifestyles characterized by homelessness, frequent arrests, and low social/family support; as well as their frequent use of ED and inpatient medical services. Such patients are likely to require specialized psychiatric and substance abuse care; ongoing medical care that is equipped to address the consequences of severe drug use, including intravenous drug use; and coordination with social services. Patients with low drug use severity were primarily users of marijuana, with little reported use of other drugs, less psychiatric comorbidity, and more stable lifestyles than those with more severe drug use severity. Because of their milder symptoms, these patients may benefit from a collaborative care model that integrates psychiatric and substance abuse care in the primary care setting. Patients with intermediate drug use severity may benefit from selective application of interventions suggested for patients with the highest and lowest drug use severity. Safety net primary care clinics are currently in a key position to develop a range of responses that are locally effective to serve patients with problem drug use and, in so doing, may also inform national efforts to establish PCMHs and to implement the ACA.
Conclusions
The purpose of this study was to examine baseline characteristics of people across the range of problem drug use to identify their clinical needs. Results confirmed that, as a group, patients with problem drug use had an unusually high number of co-occurring medical conditions, many serious and chronic, suggesting they are likely to need ongoing medical care. Results also indicated that patients with the highest drug use severity were unusual in the frequency and degree of psychiatric and substance abuse problems they present; their unstable lifestyles characterized by homelessness, frequent arrests, and low social/family support; as well as their frequent use of ED and inpatient medical services. Such patients are likely to require specialized psychiatric and substance abuse care; ongoing medical care that is equipped to address the consequences of severe drug use, including intravenous drug use; and coordination with social services. Patients with low drug use severity were primarily users of marijuana, with little reported use of other drugs, less psychiatric comorbidity, and more stable lifestyles than those with more severe drug use severity. Because of their milder symptoms, these patients may benefit from a collaborative care model that integrates psychiatric and substance abuse care in the primary care setting. Patients with intermediate drug use severity may benefit from selective application of interventions suggested for patients with the highest and lowest drug use severity. Safety net primary care clinics are currently in a key position to develop a range of responses that are locally effective to serve patients with problem drug use and, in so doing, may also inform national efforts to establish PCMHs and to implement the ACA.
