Analysis of intensive care units shows drug and alcohol abuse double risk of admission

While the personal health and safety risks of drug and alcohol abuse are well-documented, a new study by researchers at LDS Hospital and Brigham Young University suggests substance dependence increases medical costs by way of the intensive care unit.

Analysis of intensive care unit admissions at LDS Hospital in Salt Lake City shows drug and alcohol abuse make a patient twice as likely to be admitted to intensive care, according to the new study, published in the December issue of Intensive Care Medicine .

"Since these patients are admitted to an intensive care unit, which is geared to treat patients with a much higher acuity, medical costs are higher than for those admitted to a general ward in the hospital," reported Mary Suchyta, M.D., lead author and a physician at Intermountain Medical Center and LDS Hospital.

The researchers reviewed records for 742 patients admitted to LDS Hospital's intensive care unit over a one-year period. Nineteen percent of those patients had a history of drug and alcohol dependence prior to becoming critically ill. That's twice the rate of the population served by LDS Hospital.

"It appears that that patients with drug or alcohol dependence are at higher risk for intensive care unit admission compared to the general population, which would increase overall medical costs," said Ramona Hopkins, a psychology professor at BYU and researcher at Intermountain Medical Center and LDS Hospital.

Patients with drug or alcohol dependence were on average six years younger than the rest of ICU patients.

"What's alarming is that substance dependence meant that these individuals were critically ill and admitted to the ICU at a much younger age than the general population," Hopkins said. "If these individuals do not completely recover and return to work, that represents large potential societal costs."

The new study earned praise from the editors of Intensive Care Medicine, who noted that there are significant gaps in this type of knowledge in most ICU settings and while this article did not answer many of the questions posed by these gaps, it should stimulate further research and collaboration.

Both Drs. Suchyta and Hopkins agree that the detection of substance dependence earlier would allow doctors to address those issues and this may improve recovery.

"Dr. Hopkins and myself have thought for many years that patients with drug and alcohol dependence were over represented in the ICU populations that we have studied over the last 10-15 years and this study suggests that we were correct," noted Dr. Suchyta.

BYU undergrad Callie Beck is also a co-author on the new study. It's her second time publishing an academic paper alongside Hopkins. In 2006 she co-authored a study on brain imaging, a field she would like to pursue in graduate school. Beck is applying to nine graduate schools, including UCLA, Vanderbilt and the University of Maryland.

"Callie is an amazing student," Hopkins said. "She was involved in many aspects of the research, including data analysis and writing. That level of experience will make her stand out as she applies to graduate school."