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Medical Burden of Disease Among Individuals in Recovery From Alcohol and Other Drug Problems in the United States

Findings From the National Recovery Survey

Eddie, David PhD; Greene, M. Claire PhD, MPH; White, William L. MA; Kelly, John F. PhD

doi: 10.1097/ADM.0000000000000512
Original Research

Objectives: The medical sequalae of alcohol and other drug (AOD) problems exact a prodigious personal and societal cost, but little is known about the specific prevalence of such medical problems, and their relationship to quality of life and indices of well-being among those recovering from problematic AOD use. To better characterize the lifetime physical disease burden, this study investigated the prevalence of medical conditions commonly caused or exacerbated by excessive and chronic AOD exposure in a nationally representative sample of US adults in AOD problem recovery. Comparisons were made to the general US population. Demographic and clinical correlates of disease prevalence were also investigated along with the relationship between distinct medical conditions and indices of quality of life/well-being.

Methods: Cross-sectional nationally representative survey of the US adult population who report resolving an AOD problem (n = 2002). Weighted lifetime prevalence of common medical conditions were estimated and compared to the US population. Demographic and clinical correlates of medical conditions, and also overall disease burden, were estimated using logistic regression.

Results: Relative to the general population, prevalence of hepatitis C, chronic obstructive pulmonary disease, heart disease, and diabetes were elevated. Likelihood of having a lifetime diagnosis of a specific disease was related to primary substance used and sex. Quality of life was lower among those with physical disease histories relative to those without.

Conclusions: Findings highlight the increased medical burden associated with AOD problems, and speak to the need for earlier and more sustained intervention for AOD problems, greater integration of addiction treatment and primary health care, and longitudinal research to explore the complex, dynamic relationships between AOD use and physical disease.

Recovery Research Institute, Center for Addiction Medicine, Massachusetts General Hospital, Harvard Medical School (DE, JFK); Department of Psychiatry, Columbia University Medical Center & New York State Psychiatric Institute (MCG); Chestnut Health Systems (WLW).

Send correspondence to David Eddie, PhD, Recovery Research Institute, 151 Merrimac St. 6th Floor, Boston, MA 02114. E-mail:

Received 28 November, 2018

Accepted 27 January, 2019

The authors report no conflicts of interest.

© 2019 American Society of Addiction Medicine