Introduction

This concept defines substance use disorders / substance abuse and describes how this medical condition has been defined in MCHP research. This includes a list of databases where this information resides, the ICD diagnosis codes that are used to define it, and a list of MCHP research that has investigated substance use disorders / substance abuse, with links to the research results and findings in this research.

Substance use disorders / substance abuse has been defined as the excess use of and reliance on a drug, alcohol, or other chemical that leads to severe negative effects on the individual's health and well-being or to the welfare of others.

Technical Definition of Substance Use Disorders / Substance Abuse

The technical definition of substance use disorders / substance abuse using administrative data includes:

• Data Sources:
  
  • Hospital Abstracts data; and
    
  • Medical Services (Physician Claims) data.
  
  
• Code Values and Conditions: - defined as Manitoba residents with:
  
  
  • one or more hospitalization with a diagnosis for alcohol or drug psychoses, alcohol or drug dependence, or nondependent abuse of drugs, using:
    
    
    • ICD-9-CM codes: 291 (alcoholic psychoses), 292 (drug psychoses), 303 (alcohol dependence), 304 (drug dependence), or 305 (nondependent abuse of drugs); OR
      
    • ICD-10-CA codes: F10-F19 (mental and behavioural disorders due to psychoactive substance use) and F55 (abuse of non-dependence-producing substances). NOTE: In Chartier et al. (2016) and Brownell et al. (2020), they included two additional ICD-10-CA diagnosis codes related to hospitalizations in their definition: Z50.2 (alcohol rehabilitation) and Z50.3 (drug rehabilitation); OR
    
    
  • one or more physician visits with a diagnosis for alcohol or drug psychoses, alcohol or drug dependence, or nondependent abuse of drugs using ICD-9-CM codes 291, 292, 303, 304 or 305.
  
  NOTE: In most MCHP research, analysis is restricted to those aged 10 and older. In Chartier et al. (2015), (2016) analysis was restricted to those aged 13 and older.

MCHP Research Investigating Substance Use Disorders / Substance Abuse

The following sections describe how substance use disorders / substance abuse is investigated in several MCHP deliverables and provides links to specific information in each report.


1. Martens et al. (2004)
   
   In the Patterns of Regional Mental Illness Disorder Diagnoses and Service Use in Manitoba: A Population-Based Study deliverable by Martens et al. (2004) they investigated the treatment prevalence of substance abuse separately and as one of five cumulative disorders. For more information, see:
   
   
   • 2.2 Treatment Prevalence of Cumulative Disorders - information is presented by RHA for 1997/98 to 2001/02; and
     
   • 2.7 Treatment Prevalence of Substance Abuse - information is presented by RHA, RHA District, age and sex, and income quintile for 1997/98 to 2001/02.
     
     NOTE 1: Additional information on substance abuse is provided throughout the report.
     NOTE 2: In addition to using the Hospital Abstracts and Medical Services data, this report also used the Mental Health Management Information System (MHMIS) data.
   
   
2. Doupe et al. (2008)
   
   In the An Initial Analysis of Emergency Departments and Urgent Care in Winnipeg deliverable by Doupe et al. (2008) they investigated the use of emergency departments and Urgent Care by patients with mental illness diagnoses, including substance abuse. For more information, see:
   
   
   • Table 8.4: Distribution of Emergency Department Users by Previous Diagnosis of Select Mental Illnesses
     
   • Table 8.5: Distribution of Emergency Department Visits at HSC and SBGH by Mental Illness Diagnosed at the Time of the Visit
     
   • Table 9.3: Distribution of Urgent Care Users by Previous Diagnosis of Select Mental Diseases
   
   
3. Fransoo et al. (2009)
   
   In the Manitoba RHA Indicators Atlas 2009 deliverable by Fransoo et al. (2009) they compared the prevalence of substance abuse between 1996/97-2000/01 and 2001/02-2005/06 separately and as one of five cumulative disorders. For more information, see:
   
   
   • Table 5.1: Comparison of Mental Illness Prevalence Values
     
   • Section 5.1 - Cumulative Mental Illness that contains information on cumulative mental illness prevalence by RHA; and
     
   • Section 5.4 - Substance Abuse that contains information on substance abuse prevalence by RHA, RHA District and Winnipeg Neighbourhood Clusters
   
   
4. Martens et al. (2010)
   
   In the Profile of Metis Health Status and Healthcare Utilization in Manitoba: A Population-Based Study deliverable by Martens et al. (2010) they compared a cohort of Metis to all other Manitobans on several aspects of health. They investigated and compared the prevalence of substance abuse as one of five conditions in a cumulative mental illness condition, separately, and as a comorbidity of mental illness diagnoses. The general time frame for this study is from 2002/03 to 2006/07. For more information, see:
   
   
   • Section 4.10 - All Cause Five-Year Mortality Rates for Individuals with Cumulative Mental Illness including information by RHA, Metis Region, and Winnipeg Community Area;
     
   • Table 6.0 - Overall Key Findings of Mental Illness Indicators
     
   • Section 6.1 - Cumulative Mental Illness that contains prevalence information by RHA, Metis Region and Winnipeg Community Area.
     
   • Section 6.4 - Substance Abuse that contains prevalence information by RHA, Metis Region and Winnipeg Community Area and logistic regression modeling of cumulative mental illness.
     
   • Section 6.8 - Comorbidity of Mental Illness Diagnoses that includes information on comorbidities among specified mental illness disorders for the Metis population and all other Manitobans.
   
   
5. Martens et al. (2010)
   
   In the Health Inequities in Manitoba: Is the Socioeconomic Gap in Health Widening or Narrowing Over Time? deliverable by Martens et al. (2010) they investigated substance abuse as one of five conditions belonging to a condition termed "cumulative mental health illness". The time frame for this study covered 1984/85 to 2008/09 and includes five different 5-year periods. For more information, see Chapter 7 - Mental Health - Cumulative Health that measures five-year periods of prevalence over time, including information by RHA, income quintiles, rural and urban areas, and using Lorenz curves
   
   
6. Heaman et al. (2012)
   
   In the Perinatal Services and Outcomes in Manitoba deliverable by Heaman et al. (2012) they investigated maternal substance abuse during pregnancy as one variable in a regression model. Maternal substance abuse was defined as self-reported smoking, consuming alcohol, or illicit drug use during pregnancy on the Families First Screening form. For more information see the results of this modeling:
   
   
   • Table 7.1.2: Logistic Regression of Prenatal Psychological Distress, 2007/08-2008/09
     
   • Table 7.4.2: Logistic Regression of Postpartum Psychological Distress, 2007/08-2008/09
   
   
7. Chartier et al. (2012)
   
   In the Health and Healthcare Utilization of Francophones in Manitoba deliverable by Chartier et al. (2012) they compared the prevalence of substance abuse between a Francophone cohort and a group of Other Manitobans for 2004/05 - 2008/09, separately and as one of five cumulative mental health disorders. Rate ratios are used to compare the two groups. For more information, see:
   
   
   • section 6.1 Cumulative Mental Health Disorders
     
   • section 6.4 Substance Abuse
   
   
8. Fransoo et al. (2013)
   
   In The 2013 RHA Indicators Atlas deliverable by Fransoo et al. (2013) they compared the prevalence of substance abuse in the Manitoban population between 2002/03-2006/07 and 2007/08-2011/12. For more information, see section 5.2 Substance Abuse Prevalence that includes information by current (5) and former (11) RHAs, RHA Districts, and Winnipeg Neighbourhood Clusters.
   
   
9. Chartier et al. (2015)
   
   In the Care of Manitobans Living with Chronic Kidney Disease deliverable by Chartier et al. (2015) they investigated the prevalence and relative risk of substance abuse separately and as part of a term called "any mental disorder" in cohorts of patients with end stage kidney disease (ESKD), chronic kidney disease (CKD), and no CKD. For more information, see:
   
   
   • Table 4.2: Mental Disorders in Adults in End Stage Kidney Disease Patient Cohorts
     
   • Table 4.6: Mental Disorders in Adults in Chronic Kidney Disease Patient Cohorts
     
   • Table 5.2: Mental Disorders in Children in Patient Cohorts
   
   
10. Chartier et al. (2016)
    
    In The Mental Health of Manitoba's Children deliverable by Chartier et al. (2016), they investigated the prevalence of substance use disorders over time (2005/06-2008/09 and 2009/10-2012/13) for adolescents aged 13-19 years old by Health Region, Winnipeg Community Area, sex, and income quintile. For more information, see the section titled Substance Use Disorders.
    
    
11. Chartier et al. (2018)
    
    In The Mental Illness Among Adult Manitobans deliverable by Chartier et al. (2018), they investigated the prevalence of substance use disorders over two different time periods (2010/11 to 2014/15) by Health Region District, Health Region, Winnipeg Neighbourhood Cluster, Age and Sex, and income quintile. For more information, see the section titled Substance Use Disorders