90.7% of non-cannabis users meet criteria for problematic drug use, shows study

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, 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.)

"Of patients who reported any drug use in the previous 30 days, nearly two-thirds were identified as problem drug users," said lead study author Wendy Macias-Konstantopoulos, MD, MPH, or the Department of Emergency Medicine at Massachusetts General Hospital in Boston, Mass. "These patients also tended to require many more medical resources in the emergency department. 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."

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.

"Emergency patients with unmet substance abuse treatment needs incur higher health care costs than their counterparts," said Dr. Macias-Konstantopoulos. "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."