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Problem Substance Use Among Depressed Patients in Managed Primary Care

Received Nov. 12, 2001; revision received April 11, 2002; accepted April 26, 2002. From the Department of Psychiatry and Behavioral Sciences, UCLA Neuropsychiatric Institute; RAND, Santa Monica, Calif.; and the Robert Wood Johnson Medical School, New Brunswick, N.J. Address reprint requests to Dr. Roeloffs, UCLA Neuropsychiatric Institute, 10920 Wilshire Blvd., Suite 300, Los Angeles, CA 90024; croeloff{at}ucla.edu (e-mail).

This study identifies characteristics associated with problem substance use among 1,187 patients with either depressive symptoms (44%) or depressive disorders (56%) in primary care clinics of six managed care organizations. Sedative misuse (reported by 14% of all patients) was associated with greater wealth, social phobia, and misuse of prescription opioids. Cannabis use (11%) was associated with younger age, male gender, single marital status, white ethnicity, less education, recurrent depression, agoraphobia, and hazardous alcohol use. Hazardous drinking (11%) was significantly associated with younger age, male gender, single marital status, and cannabis use. Greater understanding of substance use problems in primary care patients with depressive symptoms and disorders may aid efforts to more quickly identify, educate, and provide services for those in need.

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