More than half of patients who report "weekend-only" drug use end up expanding their drug use to weekdays, too -- suggesting that primary care clinicians should monitor patients who acknowledge "recreational" drug use, says a new study by Boston University public health and medicine researchers.
The study, published in the journal Annals of Family Medicine and led by Judith Bernstein, professor of community health sciences at the BU School of Public Health (BUSPH), recommends that clinicians use "caution in accepting recreational drug use as reassuring," and that they conduct "continued episodic monitoring" of patients who report weekend-only drug use.
The study followed 483 patients at Boston Medical Center who reported using drugs in the previous month and who completed a follow-up visit six months later. Of those who reported weekend-only use initially, only 19.2 percent retained that pattern six months later, while 54 percent were using drugs on other days of the week. Drugs most commonly used included marijuana, cocaine and opioids.
"These findings suggest the importance of periodic monitoring of 'recreational' drug use," the study says. "A single-question standardized screen can be used to elicit necessary information."
Bernstein said the findings indicate that weekend-only use "frequently progresses into daily use, and warrants continued monitoring" by clinicians.
"The real message of this paper is a monitoring message," she said. Primary care providers "are in a position to support positive behavioral change, as well as to address increases in drug-use intensity as an integral part of their role."
The study notes that weekend-only users had lower odds of increasing drug-use frequency and severity than people whose drug use was not limited to weekends. Also, the study participants were inner-city residents with recent drug use, meaning the findings might not be generalizable to the population as a whole, the authors noted.
Illegal drug use among primary care patients is estimated at five to eight percent, but often goes undetected. Any drug use, even occasional, may have an impact on disease processes and the effectiveness of prescribed medication, the authors said.
In addition to Bernstein, the study authors included: Dr. Richard Saitz, chair and professor of community health sciences at BUSPH; Debbie M. Chang, professor of biostatistics at BUSPH; Dr. Jeffrey Samet, professor of medicine at the BU School of Medicine and chief of general internal medicine at Boston Medical Center; Na Wang, statistical analyst at the BUSPH Data Coordinating Center; and Caitlin Trilla, formerly a research assistant at Boston Medical Center.
The Annals of Family Medicine