Physical and mental health problems associated with the use of alcohol and drugs.
The nature and extent of treated health problems in patients with problems related to the use of alcohol and drugs (including both licit and illicit drugs) were compared with the morbidity levels of all patients treated for all conditions in Canada. The morbidity experience of all patients with alcohol or drug (A/D) diagnoses treated as inpatients (n = 52,200 cases) in all Ontario hospitals in 1985-1986 (based on Hospital Medical Records Institute [HMRI] data) was compared with that of the total population of all inpatients treated in all Canadian hospitals using age-sex standardized morbidity ratios (SMR) and adjusting for multiple diagnoses. Of A/D cases, 32% were admitted with a primary A/D diagnosis and 68% with a secondary A/D diagnosis; 17% of A/D cases had multiple A/D diagnosis. On average, cases with a primary A/D diagnosis had 29% more diagnoses per case than all cases treated in Ontario. SMRs were highest for cases with diagnoses relating to the use or misuse of licit drugs (SMR = 13.32 and 3.51 for those with primary and secondary drug diagnoses, respectively), intermediate for illicit drug cases (SMR = 8.87 vs. 4.74 for primary and secondary diagnoses, respectively), and lowest for patients with alcohol diagnoses (SMR = 6.68 and 4.12 for primary and secondary diagnoses, respectively). Excess morbidity for alcohol cases affected more diagnostic categories and body systems, being at a higher level than for drug cases. Alcohol or drug cases had particularly high SMRs for mental disorders, infectious and parasitic conditions, and injury and poisoning diagnoses. Alcohol or drug cases had reduced reproductive morbidity: for complications of pregnancy, childbirth, and the puerperium, SMR = 0.04 to 0.24 for cases with primary A/D diagnoses and SMR = 0.12 to 0.89 for those with secondary A/D diagnoses. Cases with drug diagnoses had a considerable reduction in SMR for certain conditions originating in the perinatal period: SMR = 0.0 for cases with primary drug diagnoses and SMR = 0.0 for secondary illicit drug diagnoses cases and SMR = 0.18 for secondary licit drug diagnoses cases.
Public Health Program, College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA. madrian@the-beach.net
Manuella
M
Adrian
Shawn J
SJ
Barry
D000293:Adolescent; D000328:Adult; D000368:Aged; D019973:Alcohol-Related Disorders / Q000175:diagnosis / Q000209:etiology / Q000401:mortality* / Q000534:rehabilitation; D002170:Canada / Q000453:epidemiology; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D017831:Diagnosis, Dual (Psychiatry); D000431:Ethanol / Q000009:adverse effects; D005260:Female; D006753:Hospital Records / Q000706:statistics & numerical data; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects*; D007223:Infant; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000401:mortality / Q000534:rehabilitation; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D011041:Poisoning / Q000401:mortality; D011619:Psychotropic Drugs / Q000009:adverse effects*; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000209:etiology / Q000401:mortality* / Q000534:rehabilitation
D013287:Illicit Drugs; D011619:Psychotropic Drugs; D000431:Ethanol