How Do People Who Frequently Attend Emergency Departments for Alcohol-Related Reasons Use, View, and Experience Specialist Addiction Services?

BACKGROUND: People who frequently attend emergency departments (EDs) for alcohol-related reasons, cost health systems greatly. Although specialist addiction services may be more appropriate for their needs, drinkers often experience barriers accessing specialist alcohol-related support. OBJECTIVES: This study explores how people who frequently attend EDs for alcohol-related reasons use, view, and experience specialist addiction services. METHODS: We conducted semi-structured interviews with 30 individuals recruited from six EDs across London, United Kingdom. Data relating to participants' socio-demographic characteristics and service use were systematically coded using qualitative software, and analyzed following the Framework. RESULTS: ED usage over the last 12 months was high, whereas current use of specialist addiction services was low. We found little evidence that structural barriers were preventing participants from attending specialist services; rather, participants seemed not to require help with their alcohol use. When asked what support they desired for their drinking, only 11/30 participants identified alcohol-specific treatment. More commonly, they wanted help relating to mental health problems; social contact; paid or voluntary work; housing-related issues; or gym access. Women were more likely to be receiving, and to have support from a specialist addiction service. Conclusions/Importance: People who frequently attended EDs for alcohol-related reasons expressed low levels of interest in, and motivation for, alcohol-specific treatment but desired broader psychosocial support. Case management and assertive outreach appear to be valuable models of service delivery for this population (particularly for men). However, further qualitative and quantitative research is now needed to verify these findings in different countries, regions, and health care systems.

Rural/urban weight-loss outcomes following bariatric surgery.

Obesity disproportionately affects rural populations; however, there is limited research examining disparities in bariatric surgery outcomes between patients from rural versus urban areas. This study aimed to compare the demographic characteristics of patients undergoing bariatric surgery from rural versus urban bariatric areas and to explore differences in weight-loss outcomes between these groups. A retrospective chart review identified a sample of 170 patients (52 rural, 118 urban) who underwent Roux-en-Y gastric bypass or vertical sleeve gastrectomy procedures over a 1-year period. Data collected included age, race, gender, insurance status, surgery type, height, and pre- and postoperative weights at 3 and 6 months. Significant differences in race, ethnicity, and surgery type were observed between rural/urban patients (ps < 0.05). Patients from rural areas demonstrated significantly greater percent total weight losses at 3 months (p = 0.018; however, there were no significant differences between groups at 6 months (p > 0.05). The results suggest that patients from rural counties experience postoperative weight-loss outcomes comparable to those of their urban counterparts.

Racial Disparities in Substance Use by Sport Participation Among High School Students.

OBJECTIVE: The purpose of this study was to assess the association between team sport participation and substance use, and racial/ ethnic disparities, among U.S. adolescents. METHOD: Data from 6,721 male and 6,761 female high school students in the 2013 Youth Behavior Risk Survey were used. Logistic regression was used to assess the relationship between team sport participation and substance use across gender and race/ethnicity. RESULTS: Among males, participation in team sports was associated with increased risk for use of smokeless tobacco (odds ratio [OR] = 1.81, 95% CI [1.42, 2.32]), alcohol (OR = 1.30, 95% CI [1.11, 1.52]), and steroids (OR = 1.69, 95% CI [1.26, 2.27]), and decreased risk for use of smoked tobacco (OR = 0.80, 95% CI [0.65, 0.99]) and inhalants (OR = 0.67, 95% CI [0.53, 0.85]). Among females, participation in team sports was associated with increased risk for use of smokeless tobacco (OR = 1.49, 95% CI [1.03, 2.18]) and diet pills (OR = 1.31, 95% CI [1.02, 1.68]), and decreased risk for use of smoked tobacco (OR = 0.60, 95% CI [0.50, 0.72]), cocaine (OR = 0.66, 95% CI [0.46, 0.94]), and prescription drugs (OR = 0.77, 95% CI [0.67, 0.89]). When examined within specific racial/ethnic groups, these patterns were not consistent. CONCLUSIONS: High school athletes are at increased risk for use of smokeless tobacco as well as alcohol, steroids, and diet pills. At the same time, they are at lower risk for use of smoked tobacco, inhalants, and cocaine, compared with non-athlete peers. Specific intersections of race/ethnicity and gender demonstrated deviations from these patterns.