Physical conditions and associated health service utilization among individuals with substance-related disorders

Background: The use of psychoactive substances has a varied impact on physical health, ranging from acute conditions to chronic diseases. Substance-related disorders (SRD) are associated with higher disability-adjusted life years and mortality rates due to physical conditions. Current health research focuses on specific diseases in clinical samples, lacking comprehensive epidemiological data for all disease categories in the general population. This study examines annual physical condition rates and health service utilization among individuals diagnosed with SRD since 2001. 

Methods: All individuals aged 12 or older who were diagnosed with SRD between April 1st, 2001 and March 31, 2022 were included. Analyses were performed using linked administrative databases on medical services covered by the Quebec Medical Health Insurance (98% of the Quebec population). All diagnoses were identified using the 9th or 10th revision of the International Classification of Diseases.

Results: Since 2001, about 1 per 1000 individuals in the general population have used medical services annually for a physical disease for which alcohol was identified as an etiological factor (e.g. alcoholic liver diseases). For all studied conditions, annual prevalences were higher among people with SRD than in the general population. The most commonly diagnosed physical conditions in individuals with SRD were related to traumatic injuries, signs or symptoms associated with an unidentified diagnosis at the moment of investigation, and diseases of the musculoskeletal system and connective tissue. Annually, individuals with SRD were more likely to be hospitalized, to visit emergency departments, and to see a medical specialist or a general practitioner for any physical health reason compared to the people without a SRD diagnosis. 

Conclusions: People with SRD may not seek direct consultation for the disorder but utilize medical services for other physical conditions. This presents an opportunity for SRD detection, engagement, and treatment. Holistic mental and physical health services are advised for the SRD population. Linked health databases offer updated snapshots of diagnosis rates and related treatments for physical diseases in SRD individuals, informing public health stakeholders. This surveillance aids in readjusting the healthcare system for tailored interventions based on diagnostic rates and service utilization patterns. Strategies are needed to enhance surveillance's impact on health services for improved management and organization.