Pharmacotherapy Prescribing to Patients with Concurrent Tobacco and Alcohol Use Disorder in a Large, Urban, Integrated Health System

Kladney, Mat; Joudrey, Paul J.; Cunningham, Chinazo O.; Bachhuber, Marcus A.

doi:10.1007/s11606-018-4806-y

Cited by 1 publication

(2 citation statements)

References 6 publications

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Section: Methodsmentioning

confidence: 99%

“…We included covariates previously associated with receipt of alcohol-related care among veterans with unhealthy alcohol use or associated with increased LTOT-related harms. 17,18,20,21 Demographic variables included age by quartiles, sex (female, male, other) race and ethnicity (Hispanic, non-Hispanic Black, non-Hispanic White, and other), copay status (VA disability compensation rating), marital status (married, not married, and unknown), rurality of zip code of VA service station (urban or rural), and AUDIT-C year. Clinical variables included smoking history (current, former, and never), severity of alcohol use (AUDIT C-score), comorbid substance use disorder diagnosis (by ICD-9 and ICD-10 diagnosis code entry; opioid use disorder, AUD, stimulant or cocaine use disorder), active prescription for sedating medication (benzodiazepine, muscle relaxant, and antipsychotic prescription), or comorbid mental health disorder diagnosis (anxiety, depression, other mood disorder, posttraumatic stress disorder [PTSD], bipolar disorder, and schizophrenia) at the time of positive AUDIT-C.…”

Section: Study Covariatesmentioning

confidence: 99%

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Alcohol-Related Care Among Veterans With Unhealthy Alcohol Use: The Role of Long-term Opioid Therapy Receipt

Joudrey,

Wang,

DeRycke

et al. 2024

J Addict Med

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Objectives Long-term opioid therapy (LTOT) is potentially dangerous among patients with unhealthy alcohol use because of possible adverse interactions. We examined receipt of alcohol-related care among patients with unhealthy alcohol use receiving LTOT and without opioid receipt. Methods We use data collected from 2009 to 2017 in the Women Veterans Cohort Study, a national cohort of Veterans engaged in Veterans Health Administration care. We included patients who screened positive for unhealthy alcohol use (score ≥5) using the Alcohol Use Disorder Identification Consumption questionnaire. Our primary exposure was LTOT (receipt of prescribed opioids for ≥90 days) versus no opioid receipt at the time of the first positive Alcohol Use Disorder Identification Consumption. Our primary outcome was receipt of brief intervention within 14 days of positive alcohol screen. Unadjusted and 4 adjusted modified Poisson regression models assessed prevalence and relative rates (RRs) of outcomes. Results Among eligible veterans, 6222 of 113,628 (5.5%) received LTOT at screening. Among patients receiving LTOT, 67.5% (95% confidence interval [CI], 66.3%–68.6%) had a documented brief intervention within 14 days of positive screen, compared with 70.1% (95% CI, 69.8%–70.4%) among patients without opioid receipt (RR, 0.96; 95% CI, 0.95–0.98; P < 0.001). Within adjusted models, the rate of brief intervention among patients receiving LTOT remained lower than patients without opioid receipt. Conclusions Among patients with unhealthy alcohol use, patients receiving LTOT had significantly lower rates of brief intervention receipt compared with those without opioid receipt, and they should be a focus for interventions to improve alcohol-related care and safer opioid prescribing.

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Section: Methodsmentioning

confidence: 99%