Lifetime substance misuse and 5-year incidence rates of emergent health problems among middle-aged adults

Abstract

Understanding the impact of prior substance misuse on emergent health problems is important to the implementation of effective preventive care. This study examined the 5-year incidence rates using a sample of middle-aged adult adoptees (N = 309, mean(age) = 44.32, standard deviation(age) = 7.28). Subjects reported on health problems at two waves of study. DSM-IV diagnoses of substance misuse were obtained using a semi-structured diagnostic interview. Finally, health services utilization and perceived health status were collected. Lifetime diagnoses of marijuana and other non-marijuana substance misuse significantly predicted new occurrences of cardiovascular and metabolic disease. Alcohol misuse predicted earlier onset of cardiovascular disease among men. Marijuana and other non-marijuana drugs predicted earlier onset of cardiovascular disease for men and women. Finally, marijuana and other non-marijuana drugs predicted earlier onset of metabolic disease among men. Substance misuse did not predict health services utilization despite higher rates of disease. These findings emphasize the need to assess lifetime substance misuse when evaluating health risks associated with use.

Figure 1

Age of onset for cardiovascular disease (CVD) by substance diagnosis. (1a) Onset age of CVD by alcohol diagnosis for men. (1b) Onset age of CVD by marijuana diagnosis for men and women combined. (1c) Onset age of CVD by other non-marijuana drug diagnosis for men and women combined.

Figure 2

Age of onset for metabolic disease by substance diagnosis. (2a) Onset age of metabolic disease by marijuana diagnosis for men. (2b) Onset age of metabolic disease by other non-marijuana drug diagnosis for men.