Mortality risk in a sample of emergency department patients who use cocaine with alcohol and/or cannabis

ABSTRACT

Background: Illicit drug use is common among emergency department (ED) patients, yet the association between drug use and subsequent mortality is not well understood. This study examines 36-month mortality rates for a sample of ED patients based on reported use of alcohol, cannabis, and cocaine, both individually and in combination. Methods: Patients (N = 1669) from 2 urban EDs were surveyed at the time of the visit. The patient survey included the Alcohol Smoking and Substance Involvement Screening Test (ASSIST) and information on physical and mental health, health care utilization, and risk factors associated with substance use. ASSIST scores were used to categorize patients into drug risk groups. Mortality information from the National Death Index was used to calculate mortality rates from 2009 to 2012. A Cox regression model identified associations between drug risk groups and mortality while controlling for patient demographics. Results: The use of cocaine and cannabis both individually and in combination was associated with significantly higher mortality risk compared with other ED patients. Conclusions: ED patients who use cannabis and cocaine have higher mortality risks than other patients. Further research is necessary to determine whether this result is stable across racial/ethnic groups.

KEYWORDS:

• Mortality risk
• polydrug use
• substance-related mortality

Funding

The authors declared the following financial support for the research, authorship, and/or publication of this article: This research was funded by Substance Abuse and Mental Health Services Administration (SAMHSA) grant TI019545. The views and opinions contained in this publication do not necessarily reflect those of SAMHSA or the US Department of Health and Human Services, and should not be construed as such. The funding organization had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Author contributions

Devin Gilmore conceived the study, performed the data analysis, and oversaw the writing process. Jennifer Zorland assisted with the review of the literature and writing process. Joanna Akin, Aaron Johnson, James Emshoff, and Gabriel Kuperminc assisted with the writing and editing process and provided feedback on the conceptualization of the study.