Schedule:
Wednesday, May 29, 2013
Pacific D-O (Hyatt Regency San Francisco)
* noted as presenting author
Ronald M. Andersen, PhD, Wasserman Professor Emeritus, University of California, Los Angeles, Los Angeles, CA
Steve Shoptaw, PhD, Professor, University of California, Los Angeles, Los Angeles, CA
Lisa Arangua, MPP, Senior Public Administrative Analyst, University of California, Los Angeles, Los Angeles, CA
Julia Yacenda-Murphy, BA, Project Manager, University of California, Los Angeles, Los Angeles, CA
Yohanna Barth-Rogers, MD, Health Educator, University of California, Los Angeles, Los Angeles, CA
Mani Vahidi, BA, Senior Field Coordinator, University of California, Los Angeles, Los Angeles, CA
Kyle Singleton, BA, Graduate Student, University of California, Los Angeles, Los Angeles, CA
Corey W. Arnold, PhD, Assistant Professor, University of California, Los Angeles, Los Angeles, CA
Barbara Leake, Phd, Senior Biostatistician, University of California, Los Angeles, Los Angeles, CA
Aims. The NIDA-funded UCLA Quit Using Drugs Intervention Trial (QUIT) conducted a RCT of a federally qualified health center (FQHC)-based very brief intervention for reducing risky stimulant use and drug-related harm in low-income, racially-diverse primary care patients in Los Angeles. The design emphasizes screening, very brief clinician advice (2-3 minutes), and two telephone drug-use health education sessions versus usual care control (240 per condition).We present findings on rates of past 3 months drug use among FQHC patients with primary care visits.
Methods. Pre-visit screening of all adults in the waiting rooms of five large FQHC organizations was conducted using a touchscreen Tablet PC. At-risk drug use was defined as casual, frequent, or binge use without the physiological or psychological manifestations of dependence, that is a score of 4 to 26 on the WHO ASSIST. Drug dependence was defined as an ASSIST score of 27+.
Results. 16,341 adult patients were approached in the waiting rooms: 13% were 18-29 years old, 27% 30-44, 57% 45-64, 3% 65 or older; 61% were male; 25% were Black, 24% Latino, 47% white, 4% other; 15% were homeless. 75% of patients in the waiting rooms were excluded from drug use screening prior to the ASSIST (e.g., visit not for themselves, non-primary care visit, refusal to participate). Among the 4,159 who completed the ASSIST, 63% reported no drug use, 65% low risk drug use, 23% moderate risk drug use, and 8% had dependent drug use. Nearly all (87-100%) risky users of a specific drug also had risky or dependent use of other substances (other drugs, alcohol, tobacco). The most common drugs used at a risky/dependent level were cannabis, cocaine/crack, methamphetamines, and prescription opiates. Drug use rates varied greatly by clinic.
Conclusions. High rates (1/3) of adult patients in FQHCs in Los Angeles have risky or dependent drug use. Integrating screening for drug use in FQHCs is feasible using tablet PCs. Stimulant use rates observed are higher than in the general population (NSDUH).
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