Coexisting social conditions and health problems among clients seeking treatment for illicit drug use in Finland: The HUUTI study

Onyeka, Ifeoma N.; Beynon, Caryl; Uosukainen, Hanna; Korhonen, Maarit Jaana; Ilomäki, Jenni; Bell, J. Simon; Paasolainen, Mika; Tasa, Niko; Tiihonen, Jari; Kauhanen, Jussi

doi:10.1186/1471-2458-13-380

Cited by 17 publications

(12 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They also continued to display severe drug problems even though almost a quarter participated in CD treatment in the 2 years prior to baseline. Taken together, these findings suggest that homeless problem drug users may require additional support to that offered in traditional CD treatment, a conclusion also suggested by others (Ibabe et al, 2014; Onyeka et al, 2013). In addition to severe drug problems, homeless participants’ acute mental health problems coupled with housing instability and criminal justice involvement may complicate their ability to comply with treatment protocols.…”

Section: Discussionsupporting

confidence: 81%

Comparison of Homeless and Non-Homeless Problem Drug Users Recruited from Primary Care Safety-Net Clinics

Krupski

Graves

Bumgardner

et al. 2015

Journal of Substance Abuse Treatment

View full text Add to dashboard Cite

Introduction The present study of homeless non-treatment-seeking problem drug users was designed to complement and extend previous studies which focused exclusively on treatment-seeking homeless problem drug users. Method Data were available for 866 primary care patients with drug problems, 30% homeless and 70% housed. Results In the 2 years prior to baseline, homeless participants had less chronic medical co-morbidity than problem drug users who were housed yet were significantly more likely to have used emergency department services, to have used them more frequently, and at higher cost. Compared to their housed counterparts, homeless participants were also more likely to have been admitted to specialized chemical dependency treatment and/or detoxification services, to have been arrested for a felony or gross misdemeanor, and to report having psychiatric problems in the prior 30 days. Conclusions Additional support may be necessary for homeless patients presenting in primary care to benefit from substance abuse treatment given their more severe drug use problems coupled with their co-morbid health, psychiatric, and psychosocial problems.

show abstract

Section: Discussionsupporting

confidence: 81%

Comparison of Homeless and Non-Homeless Problem Drug Users Recruited from Primary Care Safety-Net Clinics

Krupski

Graves

Bumgardner

et al. 2015

Journal of Substance Abuse Treatment

View full text Add to dashboard Cite

show abstract

“…Individuals who used illicit drugs and who were seeking primary care within a safety-net medical setting were found to have multiple co-existing social, psychiatric, and health problems—similar to observations reached in studies focused on treatment-seeking drug users, 3,5 studies based on national surveys, 2 or studies of such individuals presenting at EDs. 8 The present study is distinguished from previous efforts in that it was carried out in primary care clinics with patients who were not explicitly seeking substance abuse treatment.…”

Section: Discussionsupporting

confidence: 57%

“…1 There is high comorbidity between drug use disorders and both medical 2,3 and mental health 4 disorders, and drug use is commonly associated with a host of social problems such as homelessness, 5 criminal justice involvement 6 and unemployment. 5 Despite this substantial disability and comorbidity, most individuals with drug use disorders have never been treated. 2 This finding underscores the importance of the detection and referral roles of primary care physicians in the treatment of individuals with substance use disorders, who are often seen in primary care due to their heightened prevalence of medical conditions.…”

Section: Introductionmentioning

confidence: 99%

“…These changes greatly expand responsibilities of primary care providers, especially given the ACA’s expectations for better outcomes and reduced costs for those with comorbid conditions. 7 Yet, very little is known about individuals with problem drug use who present in primary care, as most information about this population comes from national surveys, 2,4 studies of treatment-seeking populations, 3,5 or studies carried out in emergency departments (EDs). 8 …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Needs of Patients with Problem Drug Use

Krupski

West

Graves

et al. 2015

The Journal of the American Board of Family Medicine

View full text Add to dashboard Cite

Introduction Illicit drug use is a serious public health problem associated with significant co-occurring medical disorders, mental disorders, and social problems. Yet most individuals with drug use disorders have never been treated, though they often seek medical treatment in primary care. The purpose of the present study was to examine baseline characteristics of persons presenting in primary care across a range of problem drug use severity to identify their clinical needs. Methods We examined socio-demographic characteristics, medical and psychiatric comorbidities, drug use severity, social and legal problems, and service utilization for 868 patients with drug problems recruited from primary care clinics in a safety-net medical setting. Based on Drug Abuse Screening Test (DAST-10) results, individuals were categorized as having low, intermediate, or substantial/severe drug use severity. Results Patients with substantial/severe drug use severity had serious drug use (opiates, stimulants, sedatives, intravenous drug use), high levels of homelessness (50%), psychiatric comorbidity (69%), arrests for serious crimes (24%), and frequent use of expensive emergency department and inpatient hospitals. Patients with low drug use severity were primarily users of marijuana with little reported use of other drugs, less psychiatric co-morbidity, and more stable lifestyles. Patients with intermediate drug use severity fell in-between the substantial/severe and low drug use severity subgroups on most variables. Conclusions Patients with highest drug use severity are likely to require specialized psychiatric and substance abuse care in addition to ongoing medical care that is equipped to address the consequences of severe/substantial drug use including intravenous drug use. Because of their milder symptoms, patients with low drug use severity 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 highest and lowest drug use severity. Primary care safety-net clinics are in a key position to develop a range of responses to serve patients with problem drug use which are locally effective and which may also inform national efforts to establish Patient-Centered Medical Homes and to implement the Affordable Care Act.

show abstract

“…Some subjects might have committed many attempts at suicide, especially in combination with substance misuse, and never been registered for a suicide attempt, which is a challenge for professionals whose task it is to identify individuals at high risk of suicide. Self-reported suicide attempts appear to be rather common, especially among drug users [ 39 ]. Furthermore, information on early adversity in the form of abuse was lacking.…”

Section: Discussionmentioning

confidence: 99%

Violent and non-violent methods of attempted and completed suicide in Swedish young men: the role of early risk factors

Stenbacka

Jokinen

2015

BMC Psychiatry

View full text Add to dashboard Cite

BackgroundThere is a paucity of studies on the role of early risk factors for the choice of methods for violent suicide attempts. Adolescent risk factors for the choice of violent or non-violent methods for suicide attempts and the risk of subsequent suicide were studied using a longitudinal design.MethodsA national Swedish cohort of 48 834 18–20-year-old young men conscripted for military service from 1969 to 1970 was followed through official registers during a 37-year period. Two questionnaires concerning their psychosocial background were answered by each conscript. Cox proportional hazard regression analyses were used to estimate the risk for different methods of attempted suicide and later suicide.ResultsA total of 1195 (2.4 %) men had made a suicide attempt and of these, 133 (11.1 %) committed suicide later. The number of suicide victims among the non-attempters was 482 (1 %). Half of the suicides occurred during the same year as the attempt. Suicide victims had earlier onset of suicidal behaviour and had more often used hanging as a method of attempted suicide than those who did not later commit suicide. The early risk factors for both violent and non-violent methods of suicide attempt were quite similar.ConclusionViolent suicide attempts, especially by hanging, are associated with a clearly elevated suicide risk in men and require special clinical and public health attention. The early risk factors related to the choice of either a violent or a non-violent suicide attempt method are interlinked and circumstantial factors temporally close to the suicide attempt, such as access to a specific method, may partly explain the choice of method.

show abstract

Coexisting social conditions and health problems among clients seeking treatment for illicit drug use in Finland: The HUUTI study

Cited by 17 publications

References 42 publications

Comparison of Homeless and Non-Homeless Problem Drug Users Recruited from Primary Care Safety-Net Clinics

Comparison of Homeless and Non-Homeless Problem Drug Users Recruited from Primary Care Safety-Net Clinics

Clinical Needs of Patients with Problem Drug Use

Violent and non-violent methods of attempted and completed suicide in Swedish young men: the role of early risk factors

Contact Info

Product

Resources

About