Utilization and cost of mental health, substance abuse, and medical services among at-risk drinkers.

The objective of this research was to examine whether users of mental health or substance abuse (MH/SA) services incurred greater costs for non-MH/SA services than nonusers of MH/SA services. Two years of health care utilization data were collected on 443 at-risk drinkers from six southern U.S. states. We then examined predictors of using MH/SA services and costs associated with non-MH/SA services. The results showed that use of MH/SA services was associated with female gender, military service, health insurance, and not being employed full-time. Unadjusted analyses indicated that non-MH/SA service costs were significantly higher among MH/SA service users than nonusers. However, this association did not endure in multivariable models. In fact, emergency department costs were significantly lower among MH/SA users. It is commonly assumed that users of MH/SA services are also heavy users of other medical services. Through multivariable models, this study found that overall costs of non-MH/SA services were similar between users and nonusers of MH/SA services.