TOBACCO, ALCOHOL, AND DRUG-USE IN A PRIMARY-CARE SAMPLE - 90-DAY PREVALENCE AND ASSOCIATED FACTORS

Background: Primary care settings are an ideal system in which to iden tify and treat substance use disorders. Objective: To ascertain the pr evalence of tobacco, alcohol, and drug use in the office of 88 primary care clinicians by gender, age and ethnicity. Method: 21,282 adults a ges 18-65 completed a self-administered Health Screening Survey while participating in a trial for early alcohol treatment. Results: The per iod prevalence of tobacco use was 27%. For alcohol: abstainers 40%, lo w risk drinkers 38%, at-risk drinkers 9%, problem drinkers 8%, and dep endent drinkers 5%. Twenty percent of the sample reported using illici t drugs five or more times in their lifetime and 5% reported current i llicit drug use. There were marked differences in alcohol use disorder s by age and ethnicity. The majority of persons who smoked reported th e desire to cut down or stop using tobacco. Significance: This is the first report on the combined prevalence of tobacco, alcohol and drug d isorders in a large sample of persons attending community-based non-ac ademic primary care clinics. This report confirms the high prevalence of these problems and suggests that patients will accurately complete a self-administered screening test such as the Health Screening Survey . The office procedures developed for this study provide Managed Care Organizations with a system of care that can be used to screen all per sons for tobacco, alcohol and drug use disorders.