Comparison of Treatment Receipt and Hospitalization Among Patients With Stimulant Use Disorder and/or Opioid Use Disorder in the Veterans Health Administration.

IF 4.2 3区 医学 Q1 SUBSTANCE ABUSE Journal of Addiction Medicine Pub Date : 2024-09-01 Epub Date: 2024-06-03 DOI:10.1097/ADM.0000000000001329
Madeline C Frost, Lara N Coughlin, Lan Zhang, Lewei Allison Lin
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Abstract

Objectives: Stimulant use is a growing problem, but little is known about service utilization among patients with stimulant use disorder (StUD). In the context of the overdose crisis, much research has focused on patients with opioid use disorder (OUD). It is unclear how the characteristics, treatment receipt, and hospitalization of patients with StUD differ from patients with OUD.

Methods: Electronic health record data were extracted for national Veterans Health Administration patients with a visit from March 1, 2020, to February 28, 2021 with StUD and/or OUD (N = 132,273). We compared patients with StUD without OUD to those with (1) co-occurring StUD + OUD and (2) OUD without StUD. Patient characteristics, substance use disorder treatment, and hospitalizations in the year following patients' first study period visit were descriptively compared. Treatment and hospitalization were also compared in adjusted regression models.

Results: Compared with patients with OUD + StUD, those with StUD without OUD were less likely to receive outpatient (adjusted odds ratio [aOR] 0.49, 95% confidence interval [CI] 0.47-0.50) or any treatment (aOR 0.47, 95% CI 0.46-0.49). Compared with patients with OUD without StUD, those with StUD without OUD were less likely to receive outpatient (aOR 0.51, 95% CI 0.49-0.52) or any treatment (aOR 0.56, 95% CI 0.54-0.58) and more likely to receive residential treatment (aOR 2.18, 95% 2.05-2.30) and to be hospitalized (aOR 1.62, 95% 1.56-1.69).

Conclusions: Patients with StUD may be less likely to receive treatment and more likely to be hospitalized than patients with OUD. Efforts focused on mitigating hospitalization and increasing treatment receipt for patients with StUD are needed.

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退伍军人健康管理局中的兴奋剂使用障碍和/或阿片类药物使用障碍患者接受治疗和住院情况的比较。
目的:使用兴奋剂是一个日益严重的问题,但人们对兴奋剂使用障碍(StUD)患者的服务利用情况知之甚少。在用药过量危机的背景下,许多研究都集中在阿片类药物使用障碍(OUD)患者身上。目前还不清楚 StUD 患者与 OUD 患者在特征、接受治疗和住院治疗方面有何不同:提取了 2020 年 3 月 1 日至 2021 年 2 月 28 日期间就诊的全国退伍军人健康管理局 StUD 和/或 OUD 患者(N = 132,273 人)的电子健康记录数据。我们将没有 OUD 的 StUD 患者与 (1) 合并 StUD + OUD 和 (2) 没有 StUD 的 OUD 患者进行了比较。我们对患者的特征、药物使用障碍治疗以及患者首次就诊后一年内的住院情况进行了描述性比较。在调整回归模型中还对治疗和住院情况进行了比较:结果:与患有 OUD + StUD 的患者相比,患有 StUD 而未患有 OUD 的患者接受门诊治疗(调整赔率 [aOR] 0.49,95% 置信区间 [CI] 0.47-0.50)或任何治疗(aOR 0.47,95% CI 0.46-0.49)的可能性较低。与未患有 StUD 的 OUD 患者相比,患有 StUD 的 OUD 患者接受门诊治疗(aOR 0.51,95% CI 0.49-0.52)或任何治疗(aOR 0.56,95% CI 0.54-0.58)的可能性较低,而接受住院治疗(aOR 2.18,95% 2.05-2.30)和住院治疗(aOR 1.62,95% 1.56-1.69)的可能性较高:结论:与 OUD 患者相比,StUD 患者接受治疗的可能性更小,住院的可能性更大。有必要努力减少 StUD 患者住院治疗的情况,并增加其接受治疗的机会。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Addiction Medicine
Journal of Addiction Medicine 医学-药物滥用
CiteScore
6.10
自引率
9.10%
发文量
260
审稿时长
>12 weeks
期刊介绍: The mission of Journal of Addiction Medicine, the official peer-reviewed journal of the American Society of Addiction Medicine, is to promote excellence in the practice of addiction medicine and in clinical research as well as to support Addiction Medicine as a mainstream medical sub-specialty. Under the guidance of an esteemed Editorial Board, peer-reviewed articles published in the Journal focus on developments in addiction medicine as well as on treatment innovations and ethical, economic, forensic, and social topics including: •addiction and substance use in pregnancy •adolescent addiction and at-risk use •the drug-exposed neonate •pharmacology •all psychoactive substances relevant to addiction, including alcohol, nicotine, caffeine, marijuana, opioids, stimulants and other prescription and illicit substances •diagnosis •neuroimaging techniques •treatment of special populations •treatment, early intervention and prevention of alcohol and drug use disorders •methodological issues in addiction research •pain and addiction, prescription drug use disorder •co-occurring addiction, medical and psychiatric disorders •pathological gambling disorder, sexual and other behavioral addictions •pathophysiology of addiction •behavioral and pharmacological treatments •issues in graduate medical education •recovery •health services delivery •ethical, legal and liability issues in addiction medicine practice •drug testing •self- and mutual-help.
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