A Population-based Study of Emergency Room Care and Drug Use

药物使用和滥用是一个主要的公共卫生问题，可能导致严重的健康后果，犯罪参与，就业问题，紧张的关系，无家可归，治疗依从性和结果差，生活质量降低。药物治疗在以社区为基础的环境中可能是有效的，但药物使用者往往没有充分利用这些治疗方案，而是在急诊室和其他急性护理环境中寻求服务。这些环境往往是解决毒品问题的最昂贵和最不有效的方法。对药物使用障碍的研究一致表明，药物问题通常需要几个月的治疗。最近的研究还表明，与药物相关的ER使用正在增加，导致公共卫生保健系统花费数十亿美元。如果考虑到其他药物治疗服务和刑事司法支出，费用甚至更高。关于酒精和相关急诊室和急性护理服务使用的负担的研究已经很发达，但对药物相关的负担和关联知之甚少。增加这方面的研究是必要的，因为最近的证据表明，药物使用对急诊室和初级保健服务环境的影响可能比酒精本身更大。这项研究是必要的，以帮助确保适当的政策和供资机制，以治疗这些慢性病在社区为基础的设置。这项研究也有助于制定有效和高效的评估和简短的干预措施，适用于急诊室和急性护理环境。最后，确定重复急诊室和急性护理服务的用户，并描述他们的临床和社会心理概况，可以导致有针对性的方法治疗的人谁对卫生保健系统的影响最大。根据主要专家的建议，这项研究将使用基于人口的调查来帮助弥补上述知识差距。本研究的具体目的是：1）检查接受急诊室服务和急性护理服务的人员的药物使用模式; 2）估计与药物使用相关的急诊室护理和急性护理服务的归因风险; 3）确定与药物相关的重复急诊室和急性护理服务使用者的服务利用模式和特征。 公共卫生相关性：本研究的目的是确定与主要药物滥用相关的急诊室使用风险。本研究还将检查药物相关急诊室护理后的治疗模式。研究结果将有助于揭示药物使用对公共护理系统的负担，并提出更有效地构建治疗和政策的方法。

DESCRIPTION (provided by applicant): Drug use and abuse is a major public health problem that can lead to serious health consequences, criminal involvement, employment problems, strained relationships, homelessness, poor treatment compliance and outcomes, and lower quality of life. Drug treatment can be effective in community-based settings, but drug users tend to under-utilize these treatment options and instead seek services in emergency rooms (ER) and other acute care settings. These settings tend to be the most expensive and least effective way of addressing drug problems. Research on substance use disorders consistently shows that drug problems typically require treatment over the course of several months. Recent research also shows that drug-related ER usage is increasing, resulting in billions of dollars in costs to the public health care system. The costs are even higher when other drug-treatment services and criminal justice expenditures are considered. Research on the burden of alcohol and associated ER and acute care service use is well developed, but little is known about drug- related burden and associations. Increasing this body of research is necessary given recent evidence which suggests that the consequences of drug use on ER and primary care service settings may be greater than alcohol alone. This research is needed to help ensure adequate policies and funding mechanisms to treat these chronic conditions in community-based settings. This research can also contribute to the development of effective and efficient assessments and brief interventions appropriate for ER and acute care settings. Finally, identifying repeat ER and acute care service users, and describing their clinical and psychosocial profiles, can lead to targeted approaches for treatment persons who have the greatest impact on the health care system. Following the recommendations of leading experts, this study will use a population- based survey to help address the foregoing gaps in knowledge. The specific aims of the study are to: 1) Examine patterns of drug use among persons who receive ER services and acute care services; 2) estimate the attributable risk of ER care and acute care services associated with drug use; and 3) identify service utilization patterns and characteristics of drug-related repeat ER and acute care service users. PUBLIC HEALTH RELEVANCE: The purpose of this study is to determine the risk of emergency room use associated with major drugs of abuse. This study will also examine patterns of treatment following drug-related emergency room care. The results will help reveal the burden of drug use on the public system of care and suggest ways to more effectively structure treatment and policy.