Medical and Mental Health Status among Drug Dependent Patients Participating in a Smoking Cessation Treatment Study

By Lima, Jennifer E.; Reid, Malcolm S. et al. | Journal of Drug Issues, Spring 2009 | Go to article overview

Medical and Mental Health Status among Drug Dependent Patients Participating in a Smoking Cessation Treatment Study


Lima, Jennifer E., Reid, Malcolm S., Smith, Jennifer L., Zhang, Yulei, Jiang, Huiping, Rotrosen, John, Nunes, Edward, Journal of Drug Issues


Substance abusers have a large number of medical and psychiatric problems, and 70-90% are smokers. The aim of this analysis was to examine the prevalence and correlates of medical and psychiatric problems in this sample of drug dependent patients who were participants in a multi-site study of smoking cessation interventions while engaged in substance abuse treatment. Descriptive analyses showed 72.8% of participants had at least one medical problem at baseline and 64.1% had at least one psychiatric diagnosis. Medical problems correlated strongly with age, smoking severity, and pack-years; psychiatric problems correlated with gender and ethnicity. Smoking cessation treatment was associated with a moderate reduction in the ASI Medical composite score. More research is needed on the possible effects of combined treatment of substance abuse and concurrent medical and psychiatric problems. Offering smoking cessation in conjunction with primary care may be a way to address the health needs of this population.

INTRODUCTION

In 2005, the National Institute on Drug Abuse (NIDA), Clinical Trials Network (CTN) completed a multi-site clinical trial looking at smoking cessation interventions in substance abuse treatment programs (Reid, Fallon, Sonne, Flammino et al., 2007; Reid, Fallon, Sonne, Nunes, et al., 2007). Though the treatment study achieved modest results, the clinic staff conducting the trial began to see the unique opportunity this trial presented in increasing participants' exposure to medical care and addressing various health problems that are endemic to the substance abusing population. The impact of addiction on various body systems is well known. The effects of alcohol on the liver (Diehl, 1998) and the brain (e.g., Wernicke-Korsakov syndrome), stimulant and opioid use on the brain (NIDA, 2008), and tobacco on the respiratory and cardiovascular systems (Centers for Disease Control, 2003), have been well documented. The complex health needs of substance users with HIV and tuberculosis, has also been well documented (Hermann & Gourevitch, 1997), as well as increased the number of emergency room visits and hospitalizations among this population (Byrne et al., 2003; Freidmann, Zhang, Henrickson, Stein & Gerstein, 2003). The health effects, however, of living a chronic lifestyle of addiction without regular access to primary care, is less well documented. Several recent studies discuss the broader health issues faced by substance abusers (DeAlba, Samet, & Saitz, 2004; Druss & von Esenwein, 2006; Friedmann et al., 2006) and their access to primary medical care. A clear picture of the broader health care needs of substance abusers and how to address these as part of their substance abuse treatment is lacking in the current literature. Features of the lifestyle of chronic drug dependence that would be expected to adversely impact health include poor self-care (e.g., poor nutrition, poor general hygiene, poor dental hygiene, and poor sleep hygiene), exposure to trauma (both psychological and physical), and failure to access health care. Chronic stress and intermittent trauma typical of the addict lifestyle are also likely to promote psychiatric problems, including depression and anxiety, both through direct effects (e.g., depression is now an established risk factor for coronary vascular disease; Williams & Steptoe, 2007) and by interfering with self-care. Those with addictions tend to seek medical or psychiatric treatment primarily in crisis situations (Byrne et al., 2003), when health care providers can focus only on the emergent medical issues, and not on other less urgent health needs.

In order to better present the medical and mental health problems experienced by persons in substance abuse treatment, we performed a secondary analysis of medical and psychiatric health status and health outcomes among patients in treatment for drug dependence who enrolled in a clinical trial of a smoking cessation intervention.

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Medical and Mental Health Status among Drug Dependent Patients Participating in a Smoking Cessation Treatment Study
Settings

Settings

Typeface
Text size Smaller Larger
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.