Somatic health of patients at an outpatient clinic for substance abuse.

BACKGROUND: Previous studies have detected a considerable degree of somatic illness among substance abusers. At our outpatient clinic for substance abuse we frequently find that referral documents provide scant information on somatic illnesses, and that patients complain of poor contact with their GP. We wished to investigate these issues.

MATERIAL AND METHOD: From September 2009 to November 2012 a total of 155 of 365 patients (42%) at an outpatient clinic for substance abuse at Levanger Hospital were included in the study. Information was gathered on somatic illnesses according to ICPC using patient-reported medical history, clinical examination, laboratory tests, review of somatic hospital records and/or information from GPs. Somatic health information in referral documents, supplementary information from GPs and patient-GP relationships were examined.

RESULTS: Altogether 119 men and 36 women with an average age of 41.7 years were included. Alcohol was the preferred intoxicant for 110 patients. We found an average of 4.2 disease diagnoses and 0.8 symptom diagnoses per patient. Dental disease was present in 69 patients, hypertension in 56, allergies in 45 and morbid obesity in 37. More serious diseases such as cancer and hepatic failure were detected. ECG showed pathology in 32 of 107 patients examined. A total of 101 referrals lacked information on somatic health. Sixty doctors replied to letters containing questions regarding somatic supplementary information. A total of 92 patients reported good or acceptable contact with their GP, 19 reported poor contact and 19 declined to answer the question, while 15 patients reported no contact and 10 reported that they had just changed their GP.

INTERPRETATION: The substance abusers in this study had several somatic diagnoses, and many reported poor contact with their GPs. There are grounds for questioning whether the requirements set by the specialist health service for adequate health provisions for patients at the outpatient clinic for substance abuse are being met.