Patterns of substance abuse treatment seeking following cocaine-related emergency department visits

Chest pain is the most common medical complaint among cocaine-using emergency department (ED) patients. Correlates of substance abuse treatment seeking were examined using 3-month post-discharge surveys from 170 ED patients admitted with cocaine-related chest pain. Four treatment categories were specified as the dependent variable in an ordered logistic regression: no treatment (74.7%), informal treatment only (7.1%), formal treatment only (5.9%), and both formal and informal treatment (12.4%). The following variables were found to be positively associated with a higher treatment category: frequency of cocaine use (OR=1.07, CI₉₅=1.01-1.15, p=0.03), global severity index (OR=2.26, CI₉₅=1.04-4.90, p=0.04), number of endorsed stigma barriers (OR= 4.40, CI₉₅=1.41-13.78, p=0.01), interpersonal consequences (OR=1.41, CI₉₅=1.01-1.88, p=0.02), and pre-baseline informal treatment (OR=6.69, CI₉₅=1.58-28.36, p=0.01). Physical consequences were found to be negatively associated with a higher treatment category (OR=0.63, CI₉₅= 0.47-0.85, p<0.01). ED visits for cocaine-related chest pain represent missed opportunities to link patients to substance abuse treatment, and interventions are needed to motivate patients to seek care.