| Characteristics | Overall (N = 868) | DAST-10 Drug Use Severity Subcategory* | P Value† | ||
|---|---|---|---|---|---|
| Low (n = 278) | Intermediate (n = 328) | Substantial/Severe (n = 262) | |||
| Medical | |||||
| CDPS medical conditions, mean (SD) | 7.42 (3.78) | 7.26 (3.86) | 7.54 (3.52) | 7.45 (4.00) | .66 |
| Emergency department | |||||
| ≥1 visit | 528 (62) | 140 (51) | 208 (64) | 180 (71) | <.001 |
| Mean visits (SD) | 2.52 (4.27) | 1.49 (2.11) | 2.26 (3.40) | 3.94 (6.20) | <.001 |
| Mean cost (SD), US$ | 1,347.69 (2,436.81) | 847.87 (1,641.90) | 1,203.20 (2,152.93) | 2,069.52 (3,212.05) | <.001 |
| Median visits | 1.00 (3.00) | 1.00 (2.00) | 1.00 (3.00) | 2.00 (5.00) | |
| Median cost, US$ | 363.81 (1,565.18) | 56.12 (1,006.36) | 265.76 (1,502.64) | 896.02 (2,792.61) | |
| Outpatient medical | |||||
| ≥1 visit | 780 (92) | 245 (90) | 307 (95) | 228 (90) | .04 |
| Mean visits (SD) | 18.94 (17.98) | 21.22 (18.62) | 19.25 (17.37) | 16.08 (17.72) | .004 |
| Mean cost (SD), US$ | 7,114.62 (8,918.87) | 7,752.36 (8,694.52) | 6,826.72 (6,964.86) | 6,796.55 (11,110.28) | .36 |
| Median visits | 14.00 (22.00) | 17.00 (25.00) | 15.00 (21.00) | 10.00 (18.00) | |
| Median cost, US$ | 4,563.84 (8,060.05) | 5,417.63 (8,647.68) | 4,677.26 (7,146.79) | 3,911.40 (6,509.43) | |
| Inpatient preceded by an ED visit | |||||
| ≥1 Inpatient admission | 227 (27) | 63 (23) | 73 (22) | 91 (36) | <.001 |
| Mean admissions (SD) | 0.44 (0.94) | 0.34 (0.77) | 0.37 (0.87) | 0.62 (1.14) | .001 |
| Mean cost (SD), US$ | 6,055.14 (22,329.21) | 4,788.08 (17,591.21) | 4,128.98 (13,675.27) | 9,876.45 (32,908.00) | .005 |
| Median admissions | 0.00 (1.00) | 0.00 (0.00) | 0.00 (0.00) | 0.00 (1.00) | |
| Median cost, US$ | 0.00 (2,928.17) | 0.00 (0.00) | 0.00 (0.00) | 0.00 (5,990.48) | |
| Psychiatric | |||||
| High psychiatric severity, ASI psychiatric status composite score >0.38‡ | 470 (54) | 114 (41) | 175 (53) | 181 (69) | <.001 |
| ASI psychiatric status composite score, mean (SD)‡§‖ | 0.38 (0.24) | 0.30 (0.24) | 0.38 (0.24) | 0.47 (0.21) | <.001 |
| ≥1 Mental illness ICD-9 diagnosis | 542 (64) | 160 (59) | 210 (65) | 172 (68) | .08 |
| Prescribed medication for psychological or emotion problems, over lifetime‡ | 619 (71) | 181 (65) | 231 (70) | 207 (79) | <.001 |
Data are reported as no. (%) of participants unless otherwise indicated. Missing values are not included in this table.
↵* Administrative data were available for 848 participants for the 2 years before study enrollment unless otherwise noted.
↵† P value is based on χ2, analysis of variance, or Kruskal-Wallis test.
↵‡ Data were available for 868 participants.
↵§ ASI composite scores range from 0 to 1, with 1 indicating greatest problem severity.
↵‖ A score >0.38 was defined as high psychiatric severity14 and represents a value of 1 standard deviation (SD) (0.22) above the mean (0.16) of the psychiatric severity composite score for nearly 3900 outpatients receiving chemical dependency treatment and assessed by the ASI.19 The 0.38 cutoff exceeds the 0.22 cutoff identified by Cacciola et al20 as the level likely to be associated with a psychiatric disorder among patients admitted to chemical dependency treatment.
ASI, Addiction Severity Index; CDPS, Chronic Illness and Disability Payment System;DAST-10, 10-item Drug Abuse Screening Test; ED, emergency department; SD, standard deviation; ICD-9, International Classification of Diseases, Ninth Revision.