SESSION TYPE: Occupational/ Environmental Lung Disease Posters
PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM
PURPOSE: Substance dependence is associated with several health related problems and higher societal cost. There are limited data on respiratory conditions associated with substance abuse. The purpose of our study is to compare the respiratory discharge diagnoses between substance-dependent and non-dependent patients.
METHODS: We conducted a retrospective cohort study using data previously collected by the SBIRT program, which is a federally-funded program designed to screen patients for substance dependence at the Cook County Health and Hospitals System. We included all patients admitted on the medicine services or short stay unit who were screened during July 2006-June 2008. Patients were stratified by type of substance used (heroin, cocaine, alcohol) and the first diagnosis listed in the ICD-9 coding schema was considered as the primary discharge diagnosis.
RESULTS: Of 11,397 patients, 341 (3.0%) were dependent on inhalational heroin, 260 (2.3%) on non-injection cocaine, and 106 (0.9%) on injection heroin. Compared to non-dependent patients, inhalational heroin-dependent patients were over three-fold more likely to have been admitted for respiratory diseases (28% vs. 8%, p<0.01); this association was strongest for asthma exacerbation (OR=7.0; 95% CI, 4.7 to 70.4, p<0.01). Of the 225 admissions for an asthma exacerbation, 44 (19.6%) had co-occurrent heroin-dependence.
CONCLUSIONS: There is a strong association between heroin dependence and hospital admission for an asthma exacerbation.
CLINICAL IMPLICATIONS: Provision of specialized substance-use treatment for inhalational heroin users will be necessary to reduce the frequency of exacerbations and repeat hospital admissions.
DISCLOSURE: The following authors have nothing to disclose: Humberto Choi, Anne Krantz, Jennifer Smith, William Trick
No Product/Research Disclosure InformationCleveland Clinic Foundation - Respiratory Institute, Cleveland, OH