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ALCOHOL AND OPIATE MISUSE IN ADULTS WITH CYSTIC FIBROSIS
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  • Christopher Richards,
  • Deborah Friedman,
  • Hanna Pinsky,
  • Elizabeth Gootkind,
  • Hang Lee,
  • Lael Yonker,
  • Anna Georgiopoulos
Christopher Richards
Massachusetts General Hospital Division of Pulmonary and Critical Care Medicine

Corresponding Author:crichards@mgh.harvard.edu

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Deborah Friedman
Massachusetts General Hospital
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Hanna Pinsky
Massachusetts General Hospital
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Elizabeth Gootkind
Massachusetts General Hospital
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Hang Lee
Massachusetts General Hospital
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Lael Yonker
Massachusetts General Hospital
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Anna Georgiopoulos
Massachusetts General Hospital
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Abstract

Background International consensus statements on depression and anxiety in adolescents and adults with CF recommend assessment for comorbid substance misuse. However, at CF centers, the frequency and impact of substance misuse have not been well characterized, and best practices for prevention, identification, and evidence-based treatment have not been routinely implemented. Methods Medical records of 148 adults with CF over 3 years were reviewed to determine the prevalence of substance misuse (alcohol or opiates) and its relationship with clinical variables and healthcare utilization. Independent-sample t-test for continuous outcomes and chi-square test for binary outcomes were used to compare groups with and without substance misuse. Results Substance misuse was documented in 28 (19%) adults with CF, equally distributed between alcohol (n=13) and opiates (n=15). Adults with substance misuse were more likely to be male. The prevalence of diagnosed anxiety and depression did not differ significantly between groups, but those with substance misuse had more severe anxiety (GAD-7: 10.0±6.1 vs. 3.3±4.4; p<0.001) and depressive symptoms (PHQ-9: 10.4±6.5 vs. 4.0±4.8; p<0.001). Adults with substance misuse had higher annual rates of missed outpatient CF visits and inpatient hospitalizations, with hospital admissions of longer mean duration. Conclusions In adults with CF, substance misuse is common and is associated with adverse indicators of emotional and physical health and service utilization, suggesting that systematic approaches to addressing substance misuse in CF clinics should be considered. Prospective, longitudinal study is warranted to elucidate the complex relationships between depression, anxiety, substance misuse, and health outcomes in individuals with CF.
13 Feb 2023Submitted to Pediatric Pulmonology
13 Feb 2023Submission Checks Completed
13 Feb 2023Assigned to Editor
13 Feb 2023Review(s) Completed, Editorial Evaluation Pending
22 Feb 2023Reviewer(s) Assigned
20 Mar 2023Editorial Decision: Revise Minor
12 May 20231st Revision Received
12 May 2023Submission Checks Completed
12 May 2023Assigned to Editor
12 May 2023Review(s) Completed, Editorial Evaluation Pending
12 May 2023Reviewer(s) Assigned
29 May 2023Editorial Decision: Accept