Elsevier

Addictive Behaviors

Volume 31, Issue 7, July 2006, Pages 1252-1258
Addictive Behaviors

Short Communication
Prevalence of substance use in a Swiss psychiatric hospital: Interview reports and urine screening

https://doi.org/10.1016/j.addbeh.2005.08.008Get rights and content

Abstract

Background

Co-morbid substance misuse is common in psychiatric disorders, has potentially severe adverse consequences and may be frequently undetected.

Aims

To measure the prevalence of substance use among patients admitted to a Swiss psychiatric hospital and to examine the potential utility of routine urine drug screening in this setting.

Method

266 inpatients were included. 238 patients completed the interview and 240 underwent a urine drug screening.

Results

Lifetime prevalence of substance use among psychiatric patients was very high for alcohol (98%; 95% CI: 96–100), benzodiazepines (86%; 95% CI: 82–91) and cannabis (53%; 95% CI: 47–60), but also for “hard drugs” like cocaine (25% ; 95% CI: 19–30) or opiates (20%; 95% CI: 15–25). Regular current use of alcohol (32%; 95% CI: 26–38) or cannabis (17%; 95% CI: 12–22) was the most frequent. Substance use was associated with male sex, younger age, unmarried status and nicotine smoking. Urine screening confirms reports from patients on recent use, and remained positive for cannabis during hospitalisation, but not for cocaine nor for opiates.

Conclusion

Substance use is frequent among psychiatric patients. Systematic interviewing of patients about their substance use remains essential, and is usually confirmed by urine screening. Urine screening can be useful to provide specific answers about recent use.

Section snippets

Background

Co-morbid substance use is common in psychiatric disorders. Compared to 17% in the general population, lifetime rates of substance abuse may rise to 47% for schizophrenic patients and 56% for bipolar patients (Regier et al., 1990). Recent reviews report a 9–36% substance use among psychiatric patients, depending on the setting and criteria for substance abuse definitions (Cantor-Graae et al., 2001, Modestin et al., 1997). Studies reported that patients with psychosis who used substances spent

Design and setting

The study was performed during a twelve month period at the Lausanne University Adult Psychiatric Hospital, which is a 107 bed hospital providing full inpatient care for a 240′000 inhabitant catchment area. Non-psychiatric patients were recruited at the Department of Surgery of the University Hospital of Lausanne. Patients of either sex who were well enough to consent and to cooperate were included. The design was two-fold: 1) cross sectional prevalence survey of substance use among every

Results

392 psychiatric patients were asked to participate to the study, 105 refused and 21 were unable to give an informed consent and excluded. 238 patients agreed to be interviewed; 28 consented to urine screening only; and 212 agreed for both urine samples and interviews. Socio-demographic data of the 238 interviewed patients are given on Table 1.

Socio-demographic and clinical factors associated with illegal substance use were male sex, unmarried status, nicotine smoker, absence of professional

Discussion

Prevalence rates of substance and alcohol abuse among Lausanne psychiatric inpatients were found to be as high as those recently found in other studies (Cantor-Graae et al., 2001, Fowler et al., 1998, Modestin et al., 1997, Mueser et al., 2000). Frequency of lifetime use was 20–25% for cocaine or opiates, 86–98% for alcohol or benzodiazepines and 53% for cannabis. The substances most frequently, currently and regularly used were alcohol (32%) and cannabis (17%), but regular use of opiates or

Acknowledgments

We are grateful to the psychiatric and chirurgical nursing staff for their help in the inclusion of patients. This study was supported in part by the Quality Funds of the Hospices du Centre Hospitalier Universitaire Vaudois and Roche Diagnostics Schweiz AG supplied reagents for drug analysis in urine at reduced costs.

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