The underreporting of drug-related episodes in a Barcelona emergency room

Trends in alcohol- and drug-related emergency department and primary care visits: data from four U.S. national surveys (1995-2010)

OBJECTIVE

The purpose of this study was to update trends in alcohol- and drug-related emergency department and primary care visits over the last 15 years in the United States.

METHOD

A trend analysis was conducted on substance-related health services visits, based on self-reported alcohol or other drug use within 6 hours before an injury and/or illness event, from four National Alcohol Surveys: 1995, 2000, 2005, and 2010.

RESULTS

A significant upward trend was found from 1995 to 2010 in alcohol-related emergency department visits but not in alcohol-related primary care visits. The odds of an alcohol-related emergency department visit doubled between 1995 and 2010 (odds ratio = 2.36). No significant trend was found in either drug-related emergency department or drug-related primary care visits between 1995 and 2010.

CONCLUSIONS

These data suggest that alcohol-related emergency department visits have increased significantly over the past 15 years, whereas drug-related emergency department visits may have stabilized. These findings underscore the opportunity provided by the emergency department for screening and brief intervention for alcohol-related problems and suggest that Healthy People 2010 objectives calling for a reduction in substance-related emergency department visits were not realized. Thus, it might be prudent to adjust Healthy People 2020 objectives accordingly.

Trends in alcohol- and drug-related ED and primary care visits: data from three US National Surveys (1995-2005)

OBJECTIVE

To evaluate trends in alcohol- and drug-related emergency department (ED) and primary care visits over the previous decade.

METHOD

A trend analysis was conducted on substance-related health services visit data, based on self-reported drinking or drug use within six hours prior to an injury or illness event, from the 1995, 2000, and 2005 National Alcohol Surveys.

RESULTS

Although an upward trend was observed in alcohol-related ED visits from 1995 to 2005, this increase was not significant. A significant trend was found for drug-related ED visits from .6% in 1995 to 3.7% in 2005 (p < .01). In multiple logistic regression, year of survey (2000 vs. 1995) was positively predictive of drug-related ED visits, controlling for gender, age, ethnicity, and health insurance coverage; however, year of survey (2005 vs. 2000) was not significant.

CONCLUSION

These data suggest that drug-related ED visits are continuing to increase, although the increase has not been as substantial between 2000 and 2005 as that which was observed between 1995 and 2000 and highlight the opportunity provided by the ED and primary care settings for screening and brief intervention for substance-related problems. These findings also suggest that Healthy People 2010 objectives calling for a reduction in substance-related visits may not be reached.

Trends in alcohol- and drug-related ER and primary care visits, 1995-2000: are Healthy People 2000 objectives met?

Data were compared between the 1995 (n = 4925) and 2000 (n = 7612) National Alcohol Surveys to determine whether Healthy People 2000 objectives of a reduction in alcohol- and drug-related emergency room (ER) visits were met. Year of survey (2000) was positively predictive of drug use but not of alcohol use, prior to an event for which ER and other treatment were obtained. The data suggest Healthy People 2000 objectives were not met and in fact may be related to an increase in drug abuse among those seeking any kind of health services treatment, but not to an increase in drug use in general.

Prevalence of problematic cocaine consumption in a city of southern Europe, using capture-recapture with a single list

This study aims to determine the magnitude and characteristics of problematic cocaine consumption in the city of Barcelona, Spain. Capture-recapture with a single source was used to estimate prevalence. Log-linear regression models with interaction terms were fitted to the total sample and to subgroups according to other drugs consumed. Emergency room indicator data were obtained from the Barcelona Drug Information System. Drug-related emergencies of Barcelona residents for 1999 were analyzed. During 1999, a total of 4,035 drug-related emergencies were seen in Barcelona hospitals. Of these, 1,656 (41%) involved cocaine consumption; 41% of these patients had consumed cocaine with an opiate; 29% used cocaine with other substances; and 30% used cocaine alone. It was estimated that there was a total of 25,988 problematic cocaine users (95% confidence interval 11,782-58,064), yielding a rate of 31.27 per 1,000 inhabitants aged 15 to 54 years (95% confidence interval 14.2-69.9). The number of cocaine-related emergencies was high enough to allow capture-recapture to be applied, thus obtaining an estimate of the prevalence of problematic cocaine consumption, and high enough to characterize users according to different profiles. The use of capture-recapture with a single source can be interesting for problems related to the urban context.