An investigation comparing primary and secondary substance cravings between mental health and substance use disorder program inpatients

Abstract

Background: Mental illness symptoms can trigger substance use cravings, which are strongly associated with relapse. Aim: Our study examines differences in substances craved among adults entering inpatient mental health (MH) and substance use disorder (SUD) treatment programs in 2018. Method: Our sample includes 2,486 adults; 1,686 adults admitted to MH programs and 800 adults admitted to SUD programs. We conducted chi-square tests and Fisher’s exact tests to determine group differences, with a Bonferroni correction to adjust the alpha for multiple tests. Results: We found that patients programmed to SUD services more often reported alcohol (39.99 vs. 49.63%; x2 (1, N = 2,488) =20.56, p<0.001) and opioid (8. 00% vs. 35.88%; x2 (1, N = 2,488) =299.48, p < 0.001) cravings. Patients programmed to MH primary more often reported cannabis (16. 35% vs. 1.00%; x2 (1, N=2,488) =299.48, p<0.001), stimulants (10.25% vs. 6.13%; x2(1, N =2,488) = 11.36, p < 0.001), and “other substances” cravings (21.45% vs. 3.25; x2 (2, N = 2,488) =136.52, p <0.001). Both groups mostly did not report secondary cravings. Conclusions: Because cravings can negatively impact treatment success of patients with co-occurring disorders, cravings should be assessed upon admission to mental health or SUD inpatient treatment.