Prevalence and detection of illicit drug disorders among hospitalized patients

The objective of this study was to determine the prevalence of a lifetime history of illicit drug dependence--abuse among hospitalized patients, and to determine the rate of identification of these patients by physicians. This cross-sectional study included patient interview and chart review in an acute-care teaching hospital. The participants were 235 randomly selected inpatients with medical, neurologic, or surgical diagnoses. The prevalence of life-time history of dependence--abuse of at least one class of illicit drug was 11.9%. Across all classes of drugs, hospitalized patients had higher prevalences than community estimates. Only 18% of patients had documentation of having been asked about illicit drug use compared to 49% having been asked about alcohol use. There was no significant difference in physicians' asking across clinical services: Medicine 21%, Neurology 15%, Surgery 14%. Smokers, unmarried persons, and patients without a regular physician were most likely to have been asked. Screening for drug abuse is not routinely performed and documented among hospitalized patients. Wider identification of persons at risk for drug use may allow for specific physician interventions.