Health Care Need and Utilization: A Preliminary Comparison of Injection Drug Users, Other Illicit Drug Users, and Nonusers

Abstract

This paper investigates the relationship between chronic drug use and the health care system. Data from 536 African-American, Hispanic, and non-Hispanic White men and women were analyzed to determine independent risk factors for three outcome variables: 1) Need for health care treatment, 2) Utilization of health care treatment, and 3) Failure to receive needed treatment. Nine independent demographic, health, and drug-use history variables were assessed in logistic regression models. Chronic drug users were more likely in the past year to need health care treatment, were as likely to receive some health care treatment, and were more likely not to receive needed treatment than were nonusers.

Smoking, HIV Status, and HIV Risk Behaviors in a Respondent-Driven Sample of Injection Drug Users in Baltimore, Maryland: The BeSure Study

“…Dependence, reinforcement, and polydrug use may put injection drug users at increased and prolonged risk of contracting HIV. Additionally, injection drug users are less likely to access either preventive or needed health care services which may help to reduce their HIV risk or address their substance dependencies (Chitwood, Comerford, & McCoy, 2002;Chitwood, McBride, French, & Comerford, 1999;Chitwood, Sanchez, Comerford, & McCoy, 2001;McCoy, Metsch, Chitwood, & Miles, 2001). Despite these associations, few studies have examined smoking within the context of injection drug use, HIV risk, and access to health care.…”

Exploring drug users’ attitudes and decisions regarding hepatitis C (HCV) treatment in the U.S.

“…In addition, researchers have pointed out the need to utilise a collaborative team approach to successfully treat people with a history of substance abuse for HCV that relies on the input of a number of health care providers, including primary care physicians, HCV specialists, psychiatrists/psychologists, social workers, and drug counsellors (Edlin, 2002;Sylvestre et al, 2004). Yet, many HCV-positive drug users are likely to have difficulty obtaining comprehensive evaluation and care from a multidisciplinary team of medical providers, as this population often has limited access to health care services (Bae, 1997;Chitwood, McBride, French, & Comerford, 1999;Contoreggi, Rexroad, & Lange, 1998) and people with HCV are more likely to be uninsured or have publicly-funded health care (NIH, 2002). Given the large number of medically uninsured drug users in this country and the high cost of HCV medications ($15,000 or more for a full course of treatment in the U.S.), many infected individuals have to apply for financial assistance programmes funded by pharmaceutical companies to pay for treatment (Schering-Plough, 2006).…”

On-site HIV testing in residential drug treatment units: results of a nationwide survey

“…[2][3][4] In addition, they can be encouraged to adopt risk reduction practices in order to protect themselves from reinfection and limit the spread of the virus to others with whom they share drugs and have sex. 2 Because drug users are a medically underserved and difficult-to-reach population, [5][6][7] HIV testing and counseling may not be readily available to many of these individuals. Drug treatment units are uniquely situated, however, to provide comprehensive care for drug users, [8][9][10][11][12][13] suggesting that these units can serve as important venues for HIV testing and counseling.…”