Effects of illicit drug use in an inpatient psychiatric population

Abstract

All 533 patients in the acute and subacute psychiatric wards of a VA psychiatric facility were evaluated by nursing staff for substance abuse history and for illicit drug use. Eighteen percent had a history of either drug or combined drug and alcohol problems, 40% had a history of alcohol abuse, and only 42% had no substance abuse problems. Fifty-six of the patients with a history of drug problems (58%) were illicitly using drugs in the hospital. They were compared with a group of 64 randomly chosen patients with no substance abuse history. Drug users were much younger and tended to be black; they had more re-admissions, even though their original hospital admission was much more recent. Eighty-three percent of both groups had a primary diagnosis of schizophrenia, but drug users were more likely to be diagnosed paranoid schizophrenic. The groups did not differ significantly in treatment status and progress, except that drug users were more likely to exhibit marked mood changes. Half of the drug users were taking drugs three or more times weekly. Marijuana use was by far the most common substance observed. Ten consequences of drug use occurred in at least one-third of the users on a regular basis, the most common effects being negative attitudes toward treatment, cliquishness, secretiveness, and a need for greater supervision. The treatment problems and effects of drug use were much more serious for about half of the drug users than for the others.