Disclosures: Khan reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
July 16, 2021
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Psychoactive substance use disorders rise in patients with HF

Disclosures: Khan reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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From 2008 to 2017, there was a temporal increase in the prevalence of all forms of psychoactive substance use disorders in patients hospitalized for HF, according to research in Circulation: Heart Failure.

The increase also occurred in patients hospitalized for other reasons, according to the researchers.

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“Commonly abused substances such as tobacco, alcohol and opioids have a high addiction potential and are implicated in increased hospital readmission in patients with HF. Despite the deleterious health effects of these substances, the burden and prevalence of substance abuse among patients with HF is not well characterized,” Muhammad Shahzeb Khan, MD, MSc, assistant professor of medicine at the University of Mississippi, and colleagues wrote. “We sought to assess the temporal trends in the prevalence of substance abuse disorders among patients hospitalized with HF in the United States over the past decade.”

Khan and colleagues utilized the National Inpatient Sample database to identify hospitalizations among adults, excluding pregnant women, with a primary diagnosis of HF from 2008 to 2017.

The study is limited because it is an observational study, and not all people with psychoactive substance use disorders were able to check into hospitals, the researchers wrote.

During the study period, there were 10,301,808 hospitalizations with a primary diagnosis of HF.

Researchers found that patients with HF hospitalizations were older and more likely to be men (mean age, 72.3 years; 49.3% women) compared with patients with non-HF hospitalizations (mean age, 48.3 years; 57.8% women).

The most common psychoactive substance use disorder correlated with HF hospitalizations was tobacco (9.6%), followed by alcohol (2.5%) and opioids (0.4%).

Throughout the 10-year period, a temporal increase in all psychoactive substance use disorders occurred in the HF cohort:

  • tobacco use disorder: 8.3% in 2008 vs. 10.7% in 2017; OR = 1.038; 95% CI, 1.033-1.044; annual percent change (APC), 3.8%; P for trend < .001;
  • alcohol use disorders: 2.2% in 2008 vs. 2.7% in 2017; OR = 1.021; 95% CI, 1.014-1.027; APC, 2.1%; P for trend < .001;
  • opioid use disorders: 0.1% in 2008 vs. 0.9% in 2017; OR = 1.262; 95% CI, 1.236-1.288; APC, 26.2%, P for trend < .001;
  • cocaine use disorders: 0.1% in 2008 vs. 1.1% in 2017; OR = 1.542; 95% CI, 1.497-1.589; APC, 54.2%; P for trend < .001;
  • cannabis use disorders: 0.1% in 2008 vs. 1% in 2017; OR = 2.072; 95% CI, 2.017-2.128; APC, 107.2%; P for trend < .001; and
  • other substances: 0.1% in 2008 vs. 1.1% in 2017; OR = 1.562; 95% CI, 1.523-1.603; APC, 56.3%; P for trend < .001.

In patients hospitalized for reasons other than HF, psychoactive substance use disorders also rose except for alcohol use disorders, the researchers wrote.

“In this contemporary U.S. cohort of patients hospitalized for HF, our analysis demonstrates an increase in the prevalence of substance abuse disorders across all psychoactive substances. It is important to acknowledge that comprehensive psychological and social assessment of patients with HF may help curb the silent pandemic of substance abuse in this patient cohort, which may subsequently improve patient-centered outcomes and reduce HF hospitalizations,” Khan and colleagues wrote. “Future studies should identify underlying reasons for the increase in observed prevalence and propose strategies, which may effectively curtail the increasing burden of substance abuse among patients with HF.”