Evidence map›Paper›PMID 31705770›Full record

SynthesisAddiction (Abingdon, England)2020

Frequency of health-care utilization by adults who use illicit drugs: a systematic review and meta-analysis.

Dan Lewer, Joseph Freer, Emma King, Sarah Larney, Louisa Degenhardt, Emily J Tweed, Vivian D Hope, Magdalena Harris, Tim Millar, Andrew Hayward and 2 more

Open access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Addiction (Abingdon, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 92 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
92citing papers in PubMed, 3 pooled it
15.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

92 citing papers in PubMed, 3 syntheses or guidelines pooled it, 177 citations in OpenAlex.

  1. Pooled it
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  12. Inpatient utilization among Medicaid members with substance use disorder in Oregon.Substance abuse treatment, prevention, and policy · 2026
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  17. Observational
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32 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 10 institutions in 3 countries.

Dan LewerUCL Collaborative Centre for Inclusion Health, Institute of Epidemiology and Health Care UCL, London, UK.ORCID 0000-0003-3698-7196
Joseph FreerCentre for Primary Care and Public Health, Queen Mary University of London, London, UK.
Emma KingUCL Collaborative Centre for Inclusion Health, Institute of Epidemiology and Health Care UCL, London, UK.
Sarah LarneyNational Drug and Alcohol Research Centre (NDARC), University of New South Wales, Randwick,, NSW, Australia.
Louisa DegenhardtNational Drug and Alcohol Research Centre (NDARC), University of New South Wales, Randwick,, NSW, Australia.ORCID 0000-0002-8513-2218
Emily J TweedMRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK.ORCID 0000-0001-6659-812X
Vivian D HopePublic Health Institute, Liverpool John Moores University, Liverpool, UK.ORCID 0000-0001-5712-5734
Magdalena HarrisDepartment of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, , London, UK.ORCID 0000-0001-8718-8226
Tim MillarCentre for Mental Health and Safety, The University of Manchester, Manchester, UK.
Andrew HaywardUCL Collaborative Centre for Inclusion Health, Institute of Epidemiology and Health Care UCL, London, UK.
Dan CiccaroneDepartment of Family and Community Medicine, University of California, San Francisco, CA, USA.
Katherine I MorleyNational Addictions Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.ORCID 0000-0002-2725-5535
National Institute for Health Research · GBUNSW Sydney · AUKing's College London · GBLiverpool John Moores University · GBManchester Academic Health Science Centre · GBMRC/CSO Social and Public Health Sciences Unit · GBQueen Mary University of London · GBRoyal Society of Tropical Medicine and Hygiene · GBThe University of Melbourne · AUUniversity of California, San Francisco · US

Funding

Heroin in TransitionR01DA037820 · NIDA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI CICCARONE, DANIEL H · 2015 to 2019
$3.7M
Using existing data to understand and ameliorate risk in opioid agonist therapyR01DA044170 · NIDA · UNIVERSITY OF NEW SOUTH WALES · PI DEGENHARDT, LOUISA · 2017 to 2019
$641k
Chief Scientist Office CAF/17/11Chief Scientist Office SPHSU13Chief Scientist Office SPHSU15Chief Scientist Office SPHSU17Department of Health CDF-2016-09-014Department of Health DRF-2018-11-ST2-016Medical Research Council MC_UU_12017/13Medical Research Council MC_UU_12017/15NIDA NIH HHS R01 DA037820NIDA NIH HHS R01 DA044170Wellcome Trust 109823
6 · The paper itself

Abstract

aimsTo summarize evidence on the frequency and predictors of health-care utilization among people who use illicit drugs.

designSystematic search of MEDLINE, EMBASE and PsychINFO for observational studies reporting health-care utilization published between 1 January 2000 and 3 December 2018. We conducted narrative synthesis and meta-analysis following a registered protocol (identifier: CRD42017076525). SETTING AND

participantsPeople who use heroin, powder cocaine, crack cocaine, methamphetamine, amphetamine, ecstasy/3,4-methyl​enedioxy​methamphetamine (MDMA), cannabis, hallucinogens or novel psychoactive substances; have a diagnosis of 'substance use disorder'; or use drug treatment services. MEASUREMENTS: Primary outcomes were the cumulative incidence (risk) and rate of care episodes in three settings: primary care, hospital admissions (in-patient) and emergency department (ED).

findingsNinety-two studies were included, 84% from North America and Australia. Most studies focused on people using heroin, methamphetamine or crack cocaine, or who had a diagnosis of drug dependence. We were able to conduct a meta-analysis of rates across 25 studies reporting ED episodes and 25 reporting hospital admissions, finding pooled rates of 151 [95% confidence interval (CI) = 114-201] and 41 (95% CI = 30-57) per 100 person-years, respectively; on average 4.8 and 7.1 times more often than the general population. Heterogeneity was very high and was not explained by drugs used, country of study, recruitment setting or demographic characteristics. Predictors of health-care utilization were consistent across studies and included unstable housing, drug injection and mental health problems. Opioid substitution therapy was consistently associated with reduced ED presentation and hospital admission. There was minimal research on health-care utilization by people using ecstasy/MDMA, powder cocaine, hallucinogens or novel psychoactive substances.

conclusionsPeople who use illicit drugs are admitted to emergency department or hospital several times more often than the general population.

Indexed as

Illicit DrugsAdultAmphetaminesAustraliaCrack CocaineDrug UsersEmergency Service, HospitalFemaleHeroinHospitalizationHumansMaleNorth AmericaPatient Acceptance of Health CareSubstance-Related DisordersAmphetaminesCrack CocaineHeroinIllicit DrugsHealth servicesHospitalsOpiatesPrimary Health CareStimulantsSubstance-Related Disorders

Identifiers

PMID31705770
PMCPMC7210080
OpenAlexW2987885479

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.