Post-9/11 drug- and alcohol- related hospitalizations among World Trade Center Health Registry enrollees, 2003–2010

• Published in: Drug and alcohol dependence 2018-06, Vol.187, p.55-60
• Main Authors: Hirst, Andrew, Miller-Archie, Sara A., Welch, Alice E., Li, Jiehui, Brackbill, Robert M.
• Format: Article
• Language: English
• Subjects: Adult; Alcohol hospitalization; Alcohol use; Alcoholism - epidemiology; Alcoholism - psychology; Alcohols; Cohort analysis; Drug hospitalization; Drug use; Exposure; Female; Hospitalization; Hospitalization - statistics & numerical data; Humans; Logistic Models; Longitudinal study; Male; Medical treatment; Mental disorders; Middle Aged; New York City - epidemiology; Post traumatic stress disorder; Prospective Studies; Registries; Regression analysis; September 11 Terrorist Attacks - psychology; September 11 terrorist attacks-2001; Stress Disorders, Post-Traumatic - complications; Stress Disorders, Post-Traumatic - psychology; Substance abuse; Substance use; Substance-Related Disorders - epidemiology; Substance-Related Disorders - psychology; Terrorism; Traumatic life events; World Trade Center
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/j.drugalcdep.2018.01.028

•Post-traumatic stress disorder (PTSD) increased the odds of alcohol/drug hospitalization among those exposed to 9/11.•Witnessing trauma on 9/11 was associated with drug-related hospitalization.•In a 9/11 cohort, as hospitalizations per person increased, so did PTSD prevalence. To describe patterns of drug- and alcohol-related hospitalizations among persons exposed to the 2001 World Trade Center (WTC) terrorist attacks and to assess whether 9/11-related exposures or post-9/11 post-traumatic stress disorder (PTSD) were associated with increased odds of hospitalization. Data for adult enrollees in the WTC Health Registry, a prospective cohort study, were linked to New York State (NYS) administrative hospitalization data to identify alcohol- and drug-related hospitalizations from enrollment to December 31, 2010. Logistic regression was used to analyze the associations between substance use-related hospitalization, 9/11-related exposure and PTSD. Of 41,176 NYS resident enrollees, we identified 626 (1.5%) who had at least one alcohol- or drug-related hospitalization; 53.4% (n = 591) of these hospitalizations were for alcohol only diagnoses and 46.6% (n = 515) were drug-related. Witnessing ≥3 traumatic events on 9/11 was significantly associated with having a drug-related hospitalization (AOR 1.4, 95% CI = [1.1, 1.9]). PTSD was significantly associated with both having a drug-related hospitalization as well as an alcohol only-related hospitalization. (AOR 2.6, 95% CI = [2.0, 3.3], AOR 1.8, 95% CI = [1.4, 2.3], respectively). Witnessing traumatic events and having PTSD were independently associated with substance use-related hospitalizations. Targeting people who witnessed traumatic events on 9/11 and/or who have PTSD for substance use- treatment could reduce alcohol and drug-related hospitalizations connected to 9/11.