Dataset Information

Within- and between-person associations with drug use disorder among adolescents and emerging adults presenting to an urban emergency department.

ABSTRACT:

Background

The distinction between within- and between-person associations with drug use disorder (DUD) has implications for intervention targets and content. We used longitudinal data from youth entering an urban emergency department (ED) to identify factors related to changes in DUD diagnosis, with particular emphasis on alcohol use.

Methods

Research staff recruited youth age 14-24 (n = 599) reporting any past six-month drug use from a Level-1 ED; participants were assessed at baseline and four biannual follow-ups. Participants self-reported validated measurements of peer/parental behaviors, violence/crime exposure, drug use self-efficacy, and alcohol use. Research staff performed diagnostic interviews for DUD with nine substances, post-traumatic stress disorder (PTSD), and major depressive disorder (MDD). We used repeated measures logistic regression models with person-level covariate means, and person-mean-centered covariates, as separate variables, to separate within- and between-person covariate effects.

Results

Among 2,630 assessments, 1,128 (42.9 %) were DUD diagnoses; 21.7 % were co-diagnoses with multiple drugs. Positive (aOR = 0.81, 95 %CI:[0.70, 0.94]) and negative (aOR = 1.73, 95 %CI:[1.45, 2.07]) peer behaviors related to DUD, primarily through between-person effects. Parental support (aOR = 0.92, 95 %CI:[0.83, 0.99]), community violence/crime (aOR = 1.28, 95 %CI:[1.14, 1.44]), PTSD/MDD diagnosis (aOR = 1.36, 95 %CI:[1.04, 1.79]), and alcohol use quantity (aOR = 1.06, 95 %CI:[1.02, 1.11]) were associated with DUD, showing primarily within-person effects. Other factors, such as interpersonal violence involvement (aOR = 1.47, 95 %CI:[1.21, 1.78]), showed both within- and between-person effects.

Conclusions

DUD is prevalent in this population, and within-person changes in DUD are predictable. Within-person effects suggest the importance of addressing escalating alcohol use, enhancing parental support, crime/violence exposure, and other mental health diagnoses as part of DUD intervention.

SUBMITTER: Goldstick JE

PROVIDER: S-EPMC8026687 | biostudies-literature | 2021 Apr

REPOSITORIES: biostudies-literature

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Publications

Within- and between-person associations with drug use disorder among adolescents and emerging adults presenting to an urban emergency department.

Goldstick Jason E JE Lyons Vivian H VH Myers Matthew G MG Walton Maureen A MA Heinze Justin E JE Cunningham Rebecca M RM

Drug and alcohol dependence 20210214

<h4>Background</h4>The distinction between within- and between-person associations with drug use disorder (DUD) has implications for intervention targets and content. We used longitudinal data from youth entering an urban emergency department (ED) to identify factors related to changes in DUD diagnosis, with particular emphasis on alcohol use.<h4>Methods</h4>Research staff recruited youth age 14-24 (n = 599) reporting any past six-month drug use from a Level-1 ED; participants were assessed at b ...[more]

PMID: 33631548

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Project description:BackgroundMusculoskeletal disorders (MSKDs) are among the most disabling and costly non-fatal health conditions. They may lead to long-term consequences such as chronic pain, physical limitations, and poorer quality of life. They also account for a significant proportion of emergency department visits, representing between 18% and 25% of all visits, depending on country.PurposeTo assess the health-related quality of life of patients presenting to the emergency department with a MSKD, to convert their answers to utility scores and to explore the association between diverse socio-demographic and clinical variables and patients' health-related quality of life.Patients and methodsThis is an analysis of cross-sectional data obtained during the baseline assessment performed as part of a 6-month pragmatic randomized controlled trial conducted in an academic emergency department. We included patients aged 18-80 years with a minor MSKD. The main outcome measures were health-related quality of life (five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) and utility scores (-0.148 - worse than death, 0 - dead, 0.949 - perfect health) measured with the EQ-5D-5L. Possible associations were explored by comparing scores across subgroups based on certain socio-demographic (eg, age, gender, triage score) and clinical factors (eg, pain interference on function, pain intensity) and with reference values using descriptive statistics (mean, median), rankFD ANOVAs, and χ 2 tests.ResultsSixty-nine participants completed the EQ-5D-5L. Mean and median utility scores were, respectively, 0.536 (95% CI: 0.479-0.594) and 0.531 (IQR: 0.356-0.760). Participants with higher levels of pain (<4/10: 0.741, 95% CI: 0.501-0.980; 4-7/10: 0.572, 0.500-0.644; >7/10: 0.433, 0.347-0.518) or pain interference on function (<4/10: 0.685, 95% CI: 0.605-0.764; 4-7/10: 0.463, 0.394-0.533; >7/10: 0.294, 0.126-0.463) presented significantly lower utility scores. No significant differences were found for other socio-demographic characteristics.ConclusionIn patients with MSKDs who present to the emergency department, higher levels of pain or pain interference are associated with decreased health-related quality of life. These findings need to be confirmed on a larger scale.

Dataset Information

Within- and between-person associations with drug use disorder among adolescents and emerging adults presenting to an urban emergency department.

Background

Methods

Results

Conclusions

Publications

Within- and between-person associations with drug use disorder among adolescents and emerging adults presenting to an urban emergency department.

Similar Datasets

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