The prevalence and detection of substance use disorders among inpatients ages 18 to 49: An opportunity for prevention

Background. Previous studies have found that substance use disorders are prevalent among inpatients of general medical hospitals. These studies were limited in the validity of their measures, their failure to distinguish between current and lifetime disorders, or their lack of attention to drugs other than alcohol. Methods. The current study used validated diagnostic instruments to measure current and lifetime alcohol and other drug abuse and dependence among patients ages 18 through 49. Additionally, this study assessed the sensitivity and specificity of four substance abuse screening questions. Patients were recruited from the general medical, general surgery, and orthopedics services of a university hospital in Madison, Wisconsin. The sample included 363 patients, or 86.4% of those recruited. Results. The current and lifetime prevalence rates of substance use disorders were 21.8 and 49.6%, respectively. The prevalence rates of current problems were 16.3%, alcohol only; 2.5%, other drugs only; and 3.0%, alcohol and other drugs. Males had nearly a 30% current prevalence of current substance use disorders. The CAGE Questions Adapted to Include Drugs exhibited 70.9% sensitivity and 75.7% specificity. Conclusions. At one hospital, and perhaps at others, an alcohol and drug screening, assessment, and intervention program may have the potential to prevent future health and social problems. (C) 1998 Academic Press.