title: Factors associated with substance use problem among Maryland Medicaid enrollees affected by serious mental illness.
abstract: The objective of this study was to identify long-term factors associated with substance use problem among individuals affected by severe mental illness. Prospective data come from the 1994, 1998, and 2000 waves of the Maryland Mental Health Outcomes Survey conducted among a sub-cohort of adult Medicaid recipients affected by serious mental illness. We estimated factors associated with alcohol and drug problem, as well as a hierarchy of substance use problem severity constructed from the alcohol and drug problem outcomes. Drug problem was the strongest factor associated with alcohol problem, and vice versa. Conceptualizing alcohol and drug problem separately, and as a hierarchy of severity, revealed distinct profiles of significant factors. Further research is warranted to explore the utility of modeling substance use problem in terms of a hierarchy of severity.
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
authors.forename: Krista
authors.initials: K
authors.lastname: Schladweiler
authors.forename: Pierre K
authors.initials: PK
authors.lastname: Alexandre
authors.forename: Donald M
authors.initials: DM
authors.lastname: Steinwachs
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology / Q000523:psychology; D015142:Baltimore / Q000453:epidemiology; D017831:Diagnosis, Dual (Psychiatry); D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008396:Maryland / Q000453:epidemiology; D008484:Medicaid / Q000706:statistics & numerical data*; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D014481:United States; D055815:Young Adult