title: Patterns of substance abuse treatment seeking following cocaine-related emergency department visits.
abstract: Chest pain is the most common medical complaint among cocaine-using emergency department (ED) patients. Correlates of substance abuse treatment seeking were examined using 3-month post-discharge surveys from 170 ED patients admitted with cocaine-related chest pain. Four treatment categories were specified as the dependent variable in an ordered logistic regression: no treatment (74.7%), informal treatment only (7.1%), formal treatment only (5.9%), and both formal and informal treatment (12.4%). The following variables were found to be positively associated with a higher treatment category: frequency of cocaine use (OR = 1.07, CI(95) = 1.01-1.15, p = 0.03), global severity index (OR = 2.26, CI(95) = 1.04-4.90, p = 0.04), number of endorsed stigma barriers (OR = 4.40, CI(95) = 1.41-13.78, p = 0.01), interpersonal consequences (OR = 1.41, CI(95) = 1.01-1.88, p = 0.02), and pre-baseline informal treatment (OR = 6.69, CI(95) = 1.58-28.36, p = 0.01). Physical consequences were found to be negatively associated with a higher treatment category (OR = 0.63, CI(95) = 0.47-0.85, p < 0.01). ED visits for cocaine-related chest pain represent missed opportunities to link patients to substance abuse treatment, and interventions are needed to motivate patients to seek care.
authors.affiliation: VA Mental Illness Research, Education, and Clinical Center, 2200 Fort Roots Drive, North Little Rock, AR 72114, USA. fortneyjohnc@uams.edu
authors.forename: John C
authors.initials: JC
authors.lastname: Fortney
authors.forename: Shanti Prakash
authors.initials: SP
authors.lastname: Tripathi
authors.forename: Maureen A
authors.initials: MA
authors.lastname: Walton
authors.forename: Rebecca M
authors.initials: RM
authors.lastname: Cunningham
authors.forename: Brenda M
authors.initials: BM
authors.lastname: Booth
mesh_terms: D000328:Adult; D001294:Attitude to Health; D002637:Chest Pain / Q000209:etiology* / Q000628:therapy; D019970:Cocaine-Related Disorders / Q000150:complications* / Q000628:therapy; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D016015:Logistic Models; D008297:Male; D008824:Michigan; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D012959:Socioeconomic Factors; D014193:Trauma Centers