Table 2.
Medical and Psychiatric Characteristics of Participants Overall and by DAST-10 Drug Use Severity Subcategories
| DAST-10 Drug Use Severity Subcategory* | |||||
|---|---|---|---|---|---|
| Characteristics | Overall (N = 868) |
Low (n = 278) |
Intermediate (n = 328) |
Substantial/Severe (n = 262) |
P Value† |
| 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 ED 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 (IQR) | 1.00 (3.00) | 1.00 (2.00) | 1.00 (3.00) | 2.00 (5.00) | <.001 |
| Median cost (IQR), US $ | 363.81 (1,565.18) |
56.12 (1,006.36) |
265.76 (1,502.64) |
896.02 (2,792.61) |
<.001 |
| Outpatient medical | -- | -- | -- | -- | -- |
| ≥1 Outpatient 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 (IQR) | 14.00 (22.00) | 17.00 (25.00) | 15.00 (21.00) | 10.00 (18.00) | <.001 |
| Median cost (IQR), 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) |
.004 |
| Inpatient preceded by an ED visit | -- | -- | -- | -- | -- |
| ≥1 Inpatient admissions | 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 (IQR) | 0.00 (1.00) | 0.00 (0.00) | 0.00 (0.00) | 0.00 (1.00) | <.001 |
| Median cost (IQR), US $ | 0.00 (2,928.17) | 0.00 (0.00) | 0.00 (0.00) | 0.00 (5,990.48) | <.001 |
| Psychiatric | -- | -- | -- | -- | -- |
| High psychiatric severity, ASI | 470 (54) | 114 (41) | 175 (53) | 181 (69) | <.001 |
| Psychiatric Status composite score >0.38‡ |
|||||
| 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 ICD - 9 diagnosis illness | 542 (64) | 160 (59) | 210 (65) | 172 (68) | .08 |
| Prescribed medication for psychological or emotion problems, 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 available for 848 participants for the 2 years prior to study enrollment unless otherwise noted.
P Value based on chi square, ANOVA, or Kruskal Wallis test.
Data available for 868 participants.
ASI composite scores range from 0 to 1, with 1 indicating greatest problem severity.
A score of >0.38 was defined as high psychiatric severity14 and represents a value of 1 standard deviation (.22) above the mean (.16) of the psychiatric severity composite score for nearly 3,900 chemical dependency treatment outpatients assessed by the ASI.19 The 0.38 cut-off exceeds the 0.22 cut-off identified by Cacciola et al as the level likely to be associated with a psychiatric disorder among patients admitted to chemical dependency treatment.28
DAST-10, Drug Abuse Screening Test 10-item; IQR, interquartile range; ED, emergency department; CDPS, Chronic Illness and Disability Payment System; ASI, Addiction Severity Index.