Christine Timko1, Mark Ilgen2, Marie Haverfield3, Alexandra Shelley4, Jessica Y Breland5. 1. Center for Innovation to Implementation, Department of Veterans Affairs Health Care System, Palo Alto, CA, 94304, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, 94305, USA. Electronic address: Christine.Timko@va.gov. 2. Department of Psychiatry, University of Michigan School of Medicine, 4250 Plymouth Road, Ann Arbor, MI 4109, USA; Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, 2800 Plymouth Road, Building 16, Ann Arbor, MI 48109, USA. Electronic address: marki@umich.edu. 3. Center for Innovation to Implementation, Department of Veterans Affairs Health Care System, Palo Alto, CA, 94304, USA; Center for Health Policy/Center on Primary Care and Outcomes Research, Stanford University School of Medicine, Stanford, CA, 94305, USA. Electronic address: Marie.Haverfield@va.gov. 4. Center for Innovation to Implementation, Department of Veterans Affairs Health Care System, Palo Alto, CA, 94304, USA. Electronic address: Alexandra.Shelley@va.gov. 5. Center for Innovation to Implementation, Department of Veterans Affairs Health Care System, Palo Alto, CA, 94304, USA. Electronic address: Jessica.Breland@va.gov.
Abstract
BACKGROUND: Polysubstance use, the consumption of more than one substance over a defined period, is common and associated with psychiatric problems and poor treatment adherence and outcomes. This study examined past-month polysubstance use at intake among psychiatry inpatients with co-occurring mental health and substance use disorders, and outcomes 3 months later. METHODS: Participants (n=406 psychiatry inpatients with documented mental health and substance use disorders) completed a baseline and a 3-month follow-up (84%) interview. With baseline data, a latent class analysis was conducted on substances used in the past 30days. Analyses of covariance tested for differences among classes on outcomes at 3-month follow-up. RESULTS: At baseline, three classes were estimated: Cannabis+Alcohol (35.1%), Alcohol (49.3%), and Polysubstance, notably, cocaine plus alcohol and marijuana (15.7%). At follow-up, the Polysubstance class had more severe alcohol and drug use, support for abstinence, and motivation for help-seeking, but less abstinence self-efficacy; it was most likely to attend 12-step groups. The Cannabis+Alcohol class was least likely to obtain outpatient substance use treatment, and had the lowest percent days abstinent. CONCLUSIONS: Psychiatry inpatients with co-occurring substance use and mental health disorders have varying substance use patterns that correspond to substance-related outcomes concurrently and over time. Many patients achieved abstinence for most days of the 3-month post-hospitalization period. To further increase abstinence, providers could build on polysubstance-using patients' high motivation to increase self-efficacy. In addition, because patients using mainly cannabis plus alcohol may perceive little harm from cannabis use, providers may consider modifying risk perceptions through effective education. Published by Elsevier B.V.
BACKGROUND: Polysubstance use, the consumption of more than one substance over a defined period, is common and associated with psychiatric problems and poor treatment adherence and outcomes. This study examined past-month polysubstance use at intake among psychiatry inpatients with co-occurring mental health and substance use disorders, and outcomes 3 months later. METHODS:Participants (n=406 psychiatry inpatients with documented mental health and substance use disorders) completed a baseline and a 3-month follow-up (84%) interview. With baseline data, a latent class analysis was conducted on substances used in the past 30days. Analyses of covariance tested for differences among classes on outcomes at 3-month follow-up. RESULTS: At baseline, three classes were estimated: Cannabis+Alcohol (35.1%), Alcohol (49.3%), and Polysubstance, notably, cocaine plus alcohol and marijuana (15.7%). At follow-up, the Polysubstance class had more severe alcohol and drug use, support for abstinence, and motivation for help-seeking, but less abstinence self-efficacy; it was most likely to attend 12-step groups. The Cannabis+Alcohol class was least likely to obtain outpatient substance use treatment, and had the lowest percent days abstinent. CONCLUSIONS: Psychiatry inpatients with co-occurring substance use and mental health disorders have varying substance use patterns that correspond to substance-related outcomes concurrently and over time. Many patients achieved abstinence for most days of the 3-month post-hospitalization period. To further increase abstinence, providers could build on polysubstance-using patients' high motivation to increase self-efficacy. In addition, because patients using mainly cannabis plus alcohol may perceive little harm from cannabis use, providers may consider modifying risk perceptions through effective education. Published by Elsevier B.V.
Authors: Angelo Giovanni Icro Maremmani; Mirella Aglietti; Guido Intaschi; Silvia Bacciardi Journal: Int J Environ Res Public Health Date: 2022-01-11 Impact factor: 3.390