“Problem” drug users in E.R. rooms drive up health care costs
Identifying, intervening may help control effects
Nearly two-thirds of emergency room patients who reported drug use in the previous 30 days met the criteria for having a drug problem, according to a study published online Thursday in Annals of Emergency Medicine (“Identifying Patients with Problematic Drug Use in the Emergency Department: Results of a Multi-Site Study”).
A unique position
“These patients also tended to require many more medical resources in the emergency department,” said lead study author Wendy Macias-Konstantopoulos, MD, MPH, of the Department of Emergency Medicine at Massachusetts General Hospital in Boston, Mass. “Identifying which patients have problematic drug use is an important first step for emergency providers who are in a unique position to intervene and mitigate the effects of drug abuse.
Higher health care costs
“Emergency patients with unmet substance abuse treatment needs incur higher health care costs than their counterparts. Patients with drug problems who visit the ER may present 'teachable moments.’ An emergency department-based effort to connect problematic drug users with treatment could ultimately decrease overall health care costs.”
Of emergency patients who reported any drug other than marijuana as their primary drug of use, 90.7 percent met the criteria for problematic drug use. Among patients who reported cannabis (marijuana) as their primary drug, almost half (46.6 percent) met the criteria for having a drug problem.
Type of drugs linked to age
Researchers screened patients using the Tobacco, Alcohol, Drug Questionnaire. Of 3,240 patients who reported drug use in the previous month, 64.3 percent met the criteria for problematic drug use. Non-cannabis drug users identified as problem drug users were more likely to be 30 or older and have a resource-intense ER triage level. Cannabis users identified as problem drug users were more likely to be younger than 30. Both cannabis and non-cannabis users identified as problem drug users were more likely to smoke, drink daily or binge drink alcohol and use drugs daily. Nearly all the patients (91 percent) who believed their emergency department visit was related to drug use met the criteria for problematic drug use.
Annals of Emergency Medicine is the peer-reviewed scientific journal for the American College of Emergency Physicians, the national medical society representing emergency medicine. ACEP is committed to advancing emergency care through continuing education, research, and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies. For more information, visit www.acep.org.