Excess mortality among people who report lifetime use of illegal drugs in the United States: A 20-year follow-up of a nationally representative survey

Walker, Elizabeth Reisinger; Pratt, Laura A.; Schoenborn, Charlotte A.; Druss, Benjamin G.

doi:10.1016/j.drugalcdep.2016.11.026

Cited by 45 publications

(51 citation statements)

References 34 publications

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“…Illicit drug use is associated with a myriad of health conditions, including human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV), heart disease, liver disease, soft tissue infections, hypertension, and depression(Centers for Disease Control and Prevention (CDC), 2001; Chen, Huang, Yeh, & Chien, 2015; Coughlin & Shang, 2011; D C Des Jarlais et al, 2007; Doherty et al, 1996; Kessler et al, 1996; Lucas et al, 2016; Stein, 1999; Walker, Pratt, Schoenborn, & Druss, 2016)). Despite being at increased risk for several co-morbidities, people who use drugs (PWUDs), compared with the general population, are more likely to delay seeking medical care when necessary, are less likely to utilize primary medical care and are more likely to utilize emergency rooms as their primary source of care (Chen et al, 2015; Chitwood, McBride, French, & Comerford, 1999; French, McGeary, Chitwood, & McCoy, 2000; McGeary & French, 2000).…”

Section: Introductionmentioning

confidence: 99%

Perceived discrimination among racial and ethnic minority drug users and the association with health care utilization

McKnight

Shumway²,

Masson³

et al. 2017

Journal of Ethnicity in Substance Abuse

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People who use drugs (PWUDs) are at increased risk for several medical conditions, yet they delay seeking medical care and utilize emergency rooms (ERs) as their primary source of care. Limited research regarding perceived discrimination and PWUDs’ use of health care services exists. This study explores the association between interpersonal and institutional racial/ethnic and drug use discrimination in health care settings and health care utilization among respondents (N =192) recruited from Methadone Maintenance Treatment Programs (36%), HIV Primary Care Clinics (35%) and Syringe Exchange Programs (29%) in New York City (n = 88) and San Francisco (n = 104). The Kaiser Family Foundation Survey of Race, Ethnicity and Medical Care questionnaire was utilized to assess perceived institutional racial/ethnic and drug use discrimination.. Perceived institutional discrimination was examined across race/ethnicity and by regular use of ERs, having a regular doctor and consistent health insurance. Perceived interpersonal discrimination was examined by race/ethnicity. Perceived interpersonal drug use discrimination was the most common type of discrimination experienced in health care settings. Perceptions of institutional discrimination related to race/ethnicity and drug use among Non-Hispanic Whites did not significantly differ from Non-Hispanic Blacks or Hispanics. A perception of less frequent institutional racial/ethnic and drug use discrimination in health care settings was associated with increased odds of having a regular doctor. Awareness of perceived interpersonal and institutional discrimination in certain populations and the impact on health care service utilization should inform future intervention development to help reduce discrimination and improve health care utilization among PWUDs.

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Section: Introductionmentioning

confidence: 99%

Perceived discrimination among racial and ethnic minority drug users and the association with health care utilization

McKnight

Shumway²,

Masson³

et al. 2017

Journal of Ethnicity in Substance Abuse

View full text Add to dashboard Cite

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“…[3][4][5][6] This failure to address the full spectrum of patient needs is problematic given that factors such as financial concerns, stress, and anxiety have been shown to negatively impact health outcomes, leading to lower functional status, earlier mortality, increased rates of medical complications, and higher incidence of acute hospitalization. [7][8][9][10][11][12] Primary care providers (PCPs) must balance management of acute and chronic medical conditions while also addressing an increasing number of quality and guideline-based metrics. [13][14][15] Multiple competing demands and limited time during primary care visits represent significant barriers to successful patient-provider communication and collaboration.…”

mentioning

confidence: 99%

Patient-Defined Visit Priorities in Primary Care: Psychosocial Versus Medically-Related Concerns

Santo

Uratsu

et al. 2019

J Am Board Fam Med

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Background: Primary care providers (PCPs) are often challenged to address multiple patient concerns during time-limited visits. The need for PCPs to limit the number of issues addressed may have a negative impact on discussion of patient-defined visit priorities. Methods: Using data from a recent clinical trial (Aligning Patients and Providers, ClinicalTrials.gov: NCT02707146), we examined the association between patient-defined visit priorities and subsequent provider actions taken during and after the visit. We tested the hypothesis that psychosocial concerns (eg, stress, anxiety, caregiving demands) are less likely to be addressed than traditional medical concerns. Results: We analyzed 147 patient-defined visit priorities submitted just before the visit by 109 patients (mean age, 59.0 ؎ 12.7 years; including 73.4% women, 47.7% non-White race/ethnicity). Nearly one quarter of patient-defined visit priorities were related to psychosocial concerns (35/147; 23.8%). In models adjusting for age, gender, race/ethnicity, and familiarity with PCP, patients' psychosocial priorities were significantly less likely than medical priorities to be addressed during the visit (63% vs. 88%; adjusted odds ratio [aOR], 0.16; 95% CI, 0.06 to 0.41; P < .001), to receive clinical action (51% vs. 82%; aOR, 0.15; 95% CI, 0.06 to 0.38; P < .001), or to receive post visit information from the primary care doctor (17% vs. 32%; aOR, 0.39; 95% CI, 0.14 to 1.08; P ‫؍‬ .07). Conclusions: Patient-defined psychosocial priorities are less likely to be addressed during (or immediately after) primary care visits compared with patient-defined medical priorities.

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“…This trend could be related to a high mortality well documented among DUs (36)(37)(38)(39)(40)(41) that can occur early in the course of drug use (40). Its impact will have been particularly important among the oldest DU who started their injections in the 1980s and paid a high toll to HIV before the introduction of HAART (42) and, until 1996, to overdoses before the liberalization of OST prescription as evidenced by the rst cohort study of the OFDT conducted from 1992 to 2002, which was already too late to measure the real impact of the HIV epidemic (36).…”

Section: Discussionmentioning

confidence: 86%

Is precariousness the blind spot of prevention and treatment of the use of psychoactive substances?

Chossegros

Nino

2020

Preprint

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Background and aims: Prevalence of the use of psychoactive substances is high in precarious populations. Yet the influence of precariousness on the trajectory of drug users (DUs) has rarely been studied. For the first time, we conducted such a study with a representative group of DUs.Methods: We combined a recruitment through a respondent driven sampling (RDS) with a 250 items questionnaire. The answers of our sample of 327 UDs were studied according to a precariousness score (PS).Results: The prevalence of precariousness ranged from low PS 48.9 %, average PS 30.9 % to high PS 20.2 %. Access to health services at the time of our survey concerned 61.8 % of DUs. Its prevalence was lower among DUs with the highest precariousness score (Low PS 72.5 %, Average PS 61.4 %, High PS 36.4 %) with an Odds ratio of 5.01 (CI95% 2.52-9.97; p<0.0001) between low and high PS for a continuous follow-up. A higher dropout rate was also observed among the highest PS (p<0.0001).Despite differences in their socio-economic characteristics, DUs represented a homogeneous community with respect to their use of drugs. The more precarious DUs were younger, had an earlier age of initiation of injection, of experimentation of cannabis, alcohol, heroin as well as diverted opioid substitution treatments (OST). They had a more frequent and durable use of alcohol. Precariousness was also associated with lower educational levels, less contacts with one’s parents, less search for information on the Internet for drugs and GPs for health and more housing and social rights as plans for the future.Conclusion: In France, despite the fact that specialized care is free of charge, the lower access to for the most precarious DUs and their higher drop-out rates suggest that it is not adapted to their demand, which is more oriented towards socio-economic problems than towards drug use or harm reduction. This observation is all the more important as it concerns the youngest users. Our data suggest that precariousness influences the course of drug addiction from its onset. Lack of consideration of this population limits the ability to develop effective health policies.

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Excess mortality among people who report lifetime use of illegal drugs in the United States: A 20-year follow-up of a nationally representative survey

Cited by 45 publications

References 34 publications

Perceived discrimination among racial and ethnic minority drug users and the association with health care utilization

Perceived discrimination among racial and ethnic minority drug users and the association with health care utilization

Patient-Defined Visit Priorities in Primary Care: Psychosocial Versus Medically-Related Concerns

Is precariousness the blind spot of prevention and treatment of the use of psychoactive substances?

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