Patients in treatment facilities cite alcohol, cannabis as most commonly used drugs

U.S. adults in treatment facilities evaluated for 30-day substance use patterns during 2019 cited alcohol and cannabis as principal drugs and psychiatric issues as one of their main problems, according to a study published in Morbidity and Mortality Weekly Report.

“Approximately 81,000 persons died of a drug overdose during May 2019 to May 2020; excessive alcohol use contributes to an estimated 95,000 deaths per year,” Akadia Kacha-Ochana, MPH, of the CDC, and colleagues wrote. “Persons with a substance use disorder are at elevated risk for overdose and associated harms.”

Researchers aimed to examine the prevalence of past 30-day substance use patterns as well as gauge the severity of problems experienced across seven biopsychosocial domains — alcohol, drug, employment, family, legal, medical and psychiatric.

The study utilized information from 2019 via the National Addictions Vigilance Intervention and Prevention Program Addiction Severity Index-Multimedia Version tool, a self-administered, computerized, clinical assessment method provided upon admission to a substance use treatment facility. The assessment collected data from 399 treatment centers in 37 states regarding 49,138 people aged 18 years or older (63.4% male, 65.8% white, 66.6% from metropolitan areas) who sought substance use treatment in the U.S.

Prevalence of past 30-day use overall and by demographic factors (sex, age, race and ethnicity, education, employment status, urban-rural residence and U.S. Census Bureau region of treatment site) was analyzed.

Results showed that alcohol was the most commonly reported substance used during the past 30 days (35.8%), followed by cannabis (24.9%), misuse of prescription opioids (18.5%), illicit stimulants (14%), heroin (10.2%), misuse of prescription sedatives or tranquilizers (8.5%), cocaine (7.4%), illicit fentanyl (4.9%) and misuse of prescription stimulants (1.8%).

Use of two or more substances during the 30-day window was reported by 32.6% of respondents. Among the biopsychosocial domains measured, 45.4% of adults assessed reported more severe problems with drugs, followed by psychiatric (35.2%), legal (28.8%), medical (27.4%), employment (25%), alcohol (24.2%) and family problems (22.8%). Compared with men, women reported more severe problems for all domains except alcohol. Adults aged 25 to 34 years reported more severe problems with drugs (49.9%), and those aged 55 to 64 years reported more severe problems with alcohol (41.1%). Data also revealed 67.4% of unemployed adults assessed experienced more severe drug problems, and adults who were retired or had disabilities experienced more severe psychiatric (53.3%) and medical (59.6%) issues.

“Actions to enhance comprehensive substance use programs that incorporate polysubstance use and co-occurring mental health problems into strategies for prevention, treatment and response are needed, as is expanded linkage to services,” Kacha-Ochana and colleagues wrote.