Regular Outpatient Medical and Drug Abuse Care and Subsequent Hospitalization of Persons Who Use Illicit Drugs

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Abstract
Users of illicit drugs have complex health care needs.1-5 Yet, many drug users receive medical care only when crises arise that require emergency department care or hospitalization.1,6-9 Drug users are twice as likely to visit an emergency department and nearly 7 times more likely to be hospitalized than comparably aged persons who do not use illicit drugs.10 Even in Canada, where citizens have access to universal health insurance, substance abuse accounts for approximately 8% of hospitalizations.11 In the United States, public payers are responsible for much of the hospitalization costs for persons with substance abuse.9,12 Once hospitalized, drug users also appear to have longer lengths of stay. In a cohort of human immunodeficiency virus (HIV)–infected Medicaid enrollees, we reported that drug users averaged 2 weeks longer in the hospital than nonusers following initial acquired immunodeficiency syndrome (AIDS) diagnosis.13 Patients and the public stand to benefit from the identification of factors that prevent drug users' heavy reliance on inpatient care.

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