Cherpitel Cheryl J
Alcohol Research Group, Public Health Institute, Berkeley, California 94709, USA.
Am J Drug Alcohol Abuse. 2003;29(4):789-802. doi: 10.1081/ada-120026261.
The purpose of this study was to compare changes in the prevalence of heavy problem drinking and drug use among those obtaining emergency room (ER), primary care, and other health care services between 1995 and 2000 in the U.S. general population.
Data analyzed are from the Alcohol Research Group's 1995 (n = 4925) and 2000 (n = 7612) National Alcohol Surveys. Data for the 1995 survey was based on face-to-face interviews in respondents' homes in the 48 contiguous states, while the 2000 interview was a random-digit dialing computer-assisted telephone interview of the household population in all 50 states.
Those reporting any health services utilization were less likely to report heavy drinking, two or more alcohol problems, and symptoms of alcohol dependence during the previous year in 2000 compared with 1995, but heavy or problem drinking was not predictive of health services utilization at either time. Controlling for demographic characteristics and health insurance coverage, illicit drug users were almost twice as likely [odds ratio (OR) = 1.85] compared with nonusers, to report ER utilization, and one and a half times more likely (OR = 1.55) to report primary care utilization during the past year in the 2000 survey, but drug use was not significantly predictive of health services utilization in 1995.
These data suggest that while those alcohol-involved individuals were no more likely than others to use ER and primary care services in either 1995 or 2000, those drug-involved individuals were more likely to do so in 2000, perhaps related to the fact that these individuals may be incurring more health problems associated with their drug use that require medical attention. While identification and intervention with problem drinkers in clinical settings has received a great deal of attention, drug users may be overrepresented in health service settings, and such settings also may provide a window of opportunity for screening and intervention for a reduction in drug-related problems.
本研究旨在比较1995年至2000年间美国普通人群中，在获得急诊室、初级保健和其他医疗服务的人群中，重度问题饮酒和药物使用患病率的变化。
分析的数据来自酒精研究小组1995年（n = 4925）和2000年（n = 7612）的全国酒精调查。1995年调查的数据基于对48个相邻州受访者家中的面对面访谈，而2000年的访谈是对所有50个州家庭人口的随机数字拨号计算机辅助电话访谈。
与1995年相比，2000年报告使用过任何医疗服务的人群在前一年报告重度饮酒、两个或更多酒精问题以及酒精依赖症状的可能性较小，但重度或问题饮酒在两个时间点均不能预测医疗服务的使用情况。在控制人口统计学特征和医疗保险覆盖范围后，与未使用非法药物者相比，非法药物使用者在2000年调查中报告使用急诊室的可能性几乎高出一倍（优势比[OR] = 1.85），报告过去一年使用初级保健的可能性高出一半（OR = 1.55），但1995年药物使用情况并不能显著预测医疗服务的使用情况。
这些数据表明，虽然在1995年或2000年，饮酒相关人群使用急诊室和初级保健服务的可能性并不高于其他人，但药物相关人群在2000年更有可能这样做，这可能与这些人可能因药物使用而出现更多需要医疗关注的健康问题这一事实有关。虽然在临床环境中识别和干预问题饮酒者受到了广泛关注，但药物使用者在医疗服务环境中的占比可能过高，而且这些环境也可能为筛查和干预以减少与药物相关的问题提供一个机会窗口。
