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Clinical Epidemiology of Single Versus Multiple Substance Use Disorders: Polysubstance Use Disorder.

Abstract While research on substance abuse has largely focused on people who have a single substance use disorder (SUD), many people abuse multiple substances. Studies have yet to examine the distinctive characteristics of patients diagnosed with more than 1 SUD and how those with polysubstance use disorder (PSUD) differ from those with a single SUD.
PMID
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Authors

Mayor MeshTerms

Polypharmacy

Keywords
Journal Title medical care
Publication Year Start




PMID- 28806363
OWN - NLM
STAT- MEDLINE
DA  - 20170814
DCOM- 20170822
LR  - 20170822
IS  - 1537-1948 (Electronic)
IS  - 0025-7079 (Linking)
VI  - 55 Suppl 9 Suppl 2
DP  - 2017 Sep
TI  - Clinical Epidemiology of Single Versus Multiple Substance Use Disorders:
      Polysubstance Use Disorder.
PG  - S24-S32
LID - 10.1097/MLR.0000000000000731 [doi]
AB  - OBJECTIVE: While research on substance abuse has largely focused on people who
      have a single substance use disorder (SUD), many people abuse multiple
      substances. Studies have yet to examine the distinctive characteristics of
      patients diagnosed with more than 1 SUD and how those with polysubstance use
      disorder (PSUD) differ from those with a single SUD. METHODS: National Veterans
      Health Administration data from fiscal year 2012 were used to compare veterans
      diagnosed 1 SUD to veterans diagnosed with 2-3, and >3 SUDs on demographic
      characteristics, psychiatric and medical diagnoses, medical and psychiatric
      service utilization, and psychotropic medication fills. Comparisons of the 3
      groups were based on bivariate and multiple logistic regression analyses.
      RESULTS: Of the 472,624 veterans with at least 1 diagnosed SUD, 346,329 (73.2%)
      had 1 disorder, 113,598 (24.0%) had 2-3, and 12,715 (2.7%) had >3 SUDs. Veterans 
      with higher levels of PSUD were more likely to be black and homeless, were more
      likely to have hepatic disease as well as schizophrenia, bipolar disorder, major 
      depressive disorder, and personality disorders. Higher levels of PSUD were
      associated with greater use of psychiatric inpatient care, residential and
      rehabilitative treatment, and with multiple psychotropic medication prescription 
      fills. CONCLUSIONS: Veterans with PSUD have more severe problems along several
      dimensions and use more numerous and varied services than those with 1 SUD. This 
      distinctive clinical profile warrants research to develop and evaluate methods
      for treating patients with complex multimorbid disorders that involve
      interactions between medical morbidity and psychosocial dysfunction.
FAU - Bhalla, Ish P
AU  - Bhalla IP
AD  - *Yale University Department of Psychiatry daggerVeterans Affairs New England
      Mental Illness Research, Education, and Clinical Center, West Haven double
      daggerYale University School of Public Health, New Haven, CT.
FAU - Stefanovics, Elina A
AU  - Stefanovics EA
FAU - Rosenheck, Robert A
AU  - Rosenheck RA
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Med Care
JT  - Medical care
JID - 0230027
SB  - IM
MH  - Humans
MH  - Mental Health Services/*utilization
MH  - *Polypharmacy
MH  - Substance-Related Disorders/complications/*epidemiology/ethnology
MH  - United States
MH  - United States Department of Veterans Affairs
MH  - Veterans Health/trends
EDAT- 2017/08/15 06:00
MHDA- 2017/08/23 06:00
CRDT- 2017/08/15 06:00
AID - 10.1097/MLR.0000000000000731 [doi]
AID - 00005650-201709001-00008 [pii]
PST - ppublish
SO  - Med Care. 2017 Sep;55 Suppl 9 Suppl 2:S24-S32. doi: 10.1097/MLR.0000000000000731.