title: Understanding Patterns Of High-Cost Health Care Use Across Different Substance User Groups.
abstract: Substance use contributes to significant societal burdens, including high-cost health care use. However, these burdens may vary by type of substance and level of involvement. Using the 2009-13 National Surveys on Drug Use and Health, we examined all-cause hospitalizations and estimated costs across substance use profiles for alcohol, marijuana, and other illicit drugs. For each substance, we characterized differences between abstainers, nondiagnostic users (people who used the substance but did not meet diagnostic criteria for substance use disorder), and people with substance use disorders. In a multivariate analysis, we found that the odds of hospitalization were 16 percent lower for nondiagnostic marijuana users and 11 percent lower for nondiagnostic alcohol users, compared to abstainers. Neither alcohol- nor marijuana-specific substance use disorders were associated with hospitalization. In contrast, substance use disorders for other illicit drugs were strongly associated with hospitalization: People with those disorders had 2.2 times higher odds of hospitalization relative to abstainers. A more detailed understanding of health care use in different substance user groups could inform the ongoing expansion of substance use services in the United States.
authors.affiliation: Jan Gryczynski (jgryczynski@friendsresearch.org) is a senior research scientist at the Friends Research Institute, in Baltimore, Maryland.
authors.forename: Jan
authors.initials: J
authors.lastname: Gryczynski
authors.affiliation: Robert P. Schwartz is medical director of and a senior research scientist at the Friends Research Institute.
authors.forename: Robert P
authors.initials: RP
authors.lastname: Schwartz
authors.affiliation: Kevin E. O'Grady is an associate professor of psychology at the University of Maryland, College Park.
authors.forename: Kevin E
authors.initials: KE
authors.lastname: O'Grady
authors.affiliation: Lauren Restivo is a research assistant at the Friends Research Institute.
authors.forename: Lauren
authors.initials: L
authors.lastname: Restivo
authors.affiliation: Shannon G. Mitchell is a senior research scientist at the Friends Research Institute.
authors.forename: Shannon G
authors.initials: SG
authors.lastname: Mitchell
authors.affiliation: Jerome H. Jaffe is a senior research scientist at the Friends Research Institute.
authors.forename: Jerome H
authors.initials: JH
authors.lastname: Jaffe
mesh_terms: D032882:Comprehension; D016208:Databases, Factual; D005260:Female; D017048:Health Care Costs / Q000639:trends*; D017721:Hospital Costs / Q000639:trends; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000191:economics; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies; D018570:Risk Assessment; D019966:Substance-Related Disorders / Q000191:economics* / Q000453:epidemiology*; D014481:United States
keywords: Health Reform; Hospitals; Mental Health/Substance Abuse