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To determine the prevalence of drug and alcohol use in an inner-city family planning population and to identify variables associated with a positive urine screen.We conducted blind urine drug and alcohol screening in 309 women attending an inner-city hospital family planning clinic.The prevalence of a positive urine drug and/or alcohol screen was 15.5% (48/309). Specific substance positivity rates were: marijuana 9.4%, cocaine 4.9%, alcohol 1.3%, benzodiazepines 1.0%, opiates 1.0% and amphetamines 0.3%. After controlling for other independent variables, increased age was the only predictor of having a positive drug and/or alcohol screen, while increased age and a history of a sexually transmitted disease predicted the use of drugs other than marijuana or alcohol alone.Our findings support the concept that substance use histories and urine drug screening should be considered in patients seeking family planning services. This strategy can lead to counseling and treatment for a population seeking preventive care that might otherwise not be identified.During February-June 1992, in Pennsylvania, health workers collected urine specimens from 309 women attending an inner city hospital family planning clinic in Philadelphia so researchers could determine the prevalence of drug and alcohol use in this population and to identify the variables associated with a positive urine screen for drugs and/or alcohol. 48 (15.5%) tested positive for at least one drug metabolite or alcohol. Six (2%) tested positive for at least two substances. The most frequent substances included marijuana (9.4%) and cocaine (4.9%). Other prevalence rates were 1.3% for alcohol, 1% for benzodiazepines and opiates, and 0.3% for amphetamines. The logistic regression revealed that increasing age was the only variable that predicted women having a positive urine drug and/or alcohol screen (odds ratio [OR] = 1.09). Women older than 29 years old had the highest prevalence of recent drug or alcohol use (25.4%). Increased age and history of a sexually transmitted disease (STD) were predictors of use of drugs other than marijuana or alcohol alone (OR = 1.17 and 2.18, respectively). Overall condom use stood at only 24%. Women who screened positive for drugs other than marijuana and alcohol alone had the lowest rates of current condom use (5% vs. 29%) and the highest rate of a history of an STD (70% vs. 29%). These findings indicate a need for family planning providers to screen for drugs and alcohol and to take substance use histories to identify the population at risk. Thus they will be able to provide counseling and treatment referrals, when appropriate, for a population seeking preventive care that might otherwise not be identified. |
