Substance use disorder leads to worse general health outcomes

Substance use disorder leads to worse general health outcomes
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According to new research, people with a history of hospitalisation due to substance use disorder experience significantly worse outcomes following the onset of a range of physical health conditions.  

A recent study examined the risk of mortality and loss of life years in people who developed 28 different physical health conditions. The researchers compared those who had previous hospitalisation for substance use disorder against those who had not.  

The findings have been published in The Lancet Psychiatry.

Mortality rates were higher in people with a substance use disorder

The researchers found that patients who had been hospitalised because of substance use disorder were more likely to die from all the conditions during the study period. For most subsequent health conditions, people who had substance use disorders had shorter life expectancies than individuals without substance use disorders. 

One in 20 people aged 15 years or older lives with an alcohol use disorder across the world, while around one in 100 people has some form of psychoactive drug use disorder. While substance use disorders have their own considerable effects, they are often linked to several serious physical and mental health conditions. 

The researchers analysed patient records from Czech nationwide registers of all-cause hospitalisations and deaths between 1994-2017. They estimated the risk of death and life years lost after the onset of specific physical health conditions in individuals with a history of hospitalisation for substance use disorder. 

The results show that people with substance use disorder were more likely than their counterparts to have died during the study following the development of 26 out of 28 physical health conditions. 

Seven of these conditions – including atrial fibrillation, hypertension, and ischaemic heart disease – caused the risk of death to double. Most people with a substance use disorder had shorter life expectancies than people without.  

“Substance use disorders seem to have a profound negative impact on prognosis following the development of various subsequent physical health conditions, in some cases dramatically affecting the life expectancy of the affected people,” said lead author Tomáš Formánek, a PhD student at the National Institute of Mental Health, Czechia, and the University of Cambridge.    

The reasons for poorer health outcomes are not fully understood

The reasons for this relationship are not clear. It is known that substance use has a negative impact on physical health and is often associated with lifestyle factors that affect health, such as smoking, lack of exercise, high alcohol consumption and poor diet.  

As well as this, people who have a substance use disorder are less likely to take part in screening and prevention programmes for diseases such as cancer and diabetes. They are also less likely to use preventive medication. 

 Factors not directly related to substance use, such as diagnostic overshadowing, meaning the misattribution of physical symptoms to mental disorders may also contribute to the issue. Misattribution can contribute to underdiagnosis, late diagnosis, and delayed treatment.  

“These results show how important it is not to compartmentalise health conditions into mind, brain or body. All interact leading here to dramatic increases in mortality from subsequent physical illnesses in people with substance use disorders. There are clear implications for preventive action by clinicians, health services and policy developers that all need to recognise these intersections,” said senior author Professor Peter Jones from the Department of Psychiatry, University of Cambridge. 


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