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May 10, 2001

Drug users need regular medical, drug abuse care

By Charnicia E. Huggins

NEW YORK, May 09 (Reuters Health) - Higher hospitalization rates among drug users in comparison to non-drug users may be reduced through regular drug abuse care coupled with regular medical care, results of a new study suggest.

The study involved more than 58,000 drug users enrolled in the New York State (NYS) Medicaid program.

"The NYS Medicaid program spends well over a half a billion dollars on inpatient care of drug users annually," study author Dr. Barbara J. Turner of the University of Pennsylvania in Philadelphia, told Reuters Health. "Since Medicaid is both a state and federal program, this means that not only NYS taxpayers but national taxpayers are footing a huge inpatient care bill for this population."

The investigators analyzed 1996-1997 data on hospitalization rates among drug users and found that in 1997, more than 50% of the HIV-positive users and nearly 40% of the HIV-negative users had been hospitalized at least once, staying an average of 25 to 30 days.

However, HIV-negative and HIV-positive drug users who had either regular drug abuse care or regular medical care had the lowest rates of hospitalization, according to the report in the May 9th issue of The Journal of the American Medical Association.

Individuals were said to have received regular drug abuse care if they spent at least 6 months in a drug program, and regular medical care if more than one third of their care was from one clinic, group practice or individual physician.

HIV-positive drug users who received both regular drug treatment and regular medical care were about 25% less likely to be hospitalized than those who received no treatment, the report indicates. Similarly, HIV-negative drug users who received both treatments had a less than 25% risk of being hospitalized.

"Our study affirms the enormous demand by users of illicit drugs for hospital care but also sheds light on possible solutions to this problem," Turner and colleagues write.

In light of the study findings, one possible solution involves providing regular outpatient drug treatment and medical services to drug users, according to Turner.

"Our data suggest that sufficient drug treatment slots need to be available to treat drug users, drug users must be linked to this care for at least 6 months and these individuals must receive regular medical care," she said.

"Thus, resources devoted to the outpatient care for this population have the potential to reduce the many millions of dollars spent on inpatient care. Consumers need to understand that we all pay for ignoring and/or not addressing the healthcare needs of drug users," Turner added.

SOURCE: The Journal of the American Medical Association 2001;285:2355-2362.

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