Multiple drug use disorder diagnoses among drug-involved hospitalizations in the United States: Results from the 2016 National Inpatient Sample.
Abstract
BACKGROUND:Having more than one drug use disorders (DUDs) is an increasing public
health concern, but it has been understudied. The goal of this study is to investigate
the prevalence and patterns of coexisting DUD diagnoses among inpatient hospitalizations
due to DUD in the United States. METHODS:Data were from the 2016 National Inpatient
Sample and included hospitalizations with a principal DUD diagnosis for patients aged
≥18 years (i.e., drug-involved hospitalizations, unweighted n = 31,707). The DUD diagnosis
profile was categorized into three groups: single, two, and three or more DUD diagnoses.
Generalized ordered logit models were used to examine correlates of DUD diagnosis
groups. RESULTS:Among drug-involved hospitalizations, approximately 50.1 % had multiple
coexisting DUD diagnoses (2 DUD diagnoses, 32.1 %; ≥3 DUD diagnoses, 18.0 %). Particularly,
opioid use disorder accounted for 58.6 % of drug-involved hospitalizations. Among
specific opioid-involved hospitalizations, about 51.2 % had multiple DUD diagnoses.
The most common secondary DUD diagnoses among opioid-involved hospitalizations included
cocaine (21.7 %), cannabis (18.5 %), and sedatives (18.1 %). Adjusted analyses showed
that being aged 18-25 years (vs. ≥ 26), living in areas with the lowest quartile of
household income (vs. highest), and having a secondary diagnosis of mental disorders
or tobacco/alcohol use disorder were associated with increased odds of having multiple
DUD diagnoses in the total sample and in the opioid subsample. CONCLUSIONS:Findings
suggest that healthcare providers should increase the awareness of multiple DUDs while
treating patients with DUD, especially those with opioid use disorder. More research
is needed to better characterize treatment needs for patients with multiple DUDs.
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Journal articlePermalink
https://hdl.handle.net/10161/21141Published Version (Please cite this version)
10.1016/j.drugalcdep.2020.108113Publication Info
Zhu, He; & Wu, Li-Tzy (2020). Multiple drug use disorder diagnoses among drug-involved hospitalizations in the United
States: Results from the 2016 National Inpatient Sample. Drug and alcohol dependence, 213. pp. 108113. 10.1016/j.drugalcdep.2020.108113. Retrieved from https://hdl.handle.net/10161/21141.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Li-Tzy Wu
Professor in Psychiatry and Behavioral Sciences
Education/Training: Pre- and post-doctoral training in mental health service research,
psychiatric epidemiology (NIMH T32), and addiction epidemiology (NIDA T32) from Johns
Hopkins University School of Public Health (Maryland); Fellow of the NIH Summer Institute
on the Design and Conduct of Randomized Clinical Trials.Director: Duke Community Based
Substance Use Disorder Research Program.Research interests: COVID-19, Opioid misuse,
Opioid overdose, Opioid use disorder

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