Gelberg Lillian, Natera Rey Guillermina, Andersen Ronald M, Arroyo Miriam, Bojorquez-Chapela Ietza, Rico Melvin W, Vahidi Mani, Yacenda-Murphy Julia, Arangua Lisa, Serota Martin
a Department of Family Medicine , David Geffen School of Medicine at UCLA , Los Angeles , California , USA.
b Department of Health Services , UCLA School of Public Health , Los Angeles , California , USA.
Subst Use Misuse. 2017 Feb 23;52(3):359-372. doi: 10.1080/10826084.2016.1227848. Epub 2016 Dec 21.
Given the increased use of psychoactive substances on the United States-Mexico border, a binational study (Tijuana, Mexico-Los Angeles, USA) was conducted to identify the prevalence of substance use in primary care settings.
To compare the prevalence and characteristics of patients at risk for substance use disorders in Tijuana and East Los Angeles (LA) community clinics with special attention paid to drug use.
This was an observational, cross-sectional, analytical study, comparing substance use screening results from patients in Tijuana and LA. The settings were 2 community clinics in LA and 6 in Tijuana. Participants were 2,507 adult patients in LA and 2,890 in Tijuana eligible for WHO Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) screening during March-October 2013. Patients anonymously self-administered the WHO ASSIST on a tablet PC in the clinic waiting rooms.
Of eligible patients, 96.4% completed the ASSIST in Tijuana and 88.7% in LA (mean 1.34 minutes and 4.20 minutes, respectively). The prevalence of patients with moderate-to-high substance use was higher in LA than Tijuana for each substance: drugs 19.4% vs. 5.7%, alcohol 15.2% vs. 6.5%, tobacco 20.4% vs. 16.2%. LA patients born in Mexico had 2x the odds and LA patients born in the United States had 6x the odds of being a moderate-to-high drug user compared to Tijuana patients born in Mexico.
Moderate-to-high drug use is higher in LA than in Tijuana but rates are sufficiently high in both to suggest that screening for drug use (along with alcohol and tobacco use) should be integrated into routine primary care of community clinics in both cities.
鉴于美国 - 墨西哥边境地区精神活性物质的使用有所增加，开展了一项双边研究（墨西哥蒂华纳 - 美国洛杉矶），以确定基层医疗环境中物质使用的患病率。
比较蒂华纳和东洛杉矶社区诊所中存在物质使用障碍风险的患者的患病率及特征，特别关注药物使用情况。
这是一项观察性、横断面分析研究，比较了蒂华纳和洛杉矶患者的物质使用筛查结果。研究地点为洛杉矶的2家社区诊所和蒂华纳的6家社区诊所。参与者为2013年3月至10月期间符合世界卫生组织酒精、吸烟和物质使用筛查测试（ASSIST）条件的2507名洛杉矶成年患者和2890名蒂华纳成年患者。患者在诊所候诊室通过平板电脑匿名自行完成世界卫生组织ASSIST测试。
在符合条件的患者中，蒂华纳96.4%完成了ASSIST测试，洛杉矶为88.7%（完成测试的平均时间分别为1.34分钟和4.20分钟）。每种物质的中度至高度物质使用患者患病率在洛杉矶均高于蒂华纳：药物使用方面为19.4%对5.7%，酒精使用方面为15.2%对6.5%，烟草使用方面为20.4%对16.2%。与出生在墨西哥的蒂华纳患者相比，出生在墨西哥的洛杉矶患者成为中度至高度药物使用者的几率高出2倍，出生在美国的洛杉矶患者则高出6倍。
洛杉矶的中度至高度药物使用率高于蒂华纳，但两个城市的该比率都足够高，表明药物使用筛查（以及酒精和烟草使用筛查）应纳入两个城市社区诊所的常规基层医疗服务中。
