Characteristics and Management of Patients with Substance Use Disorders Referred to a Consultation-Liaison Psychiatry Service in Lebanon

TL;DR

This study examines the characteristics and management of patients with substance use disorders in Lebanon, highlighting alcohol as the most common substance and the need for better treatment options.

Contribution

The study provides the first assessment of SUD characteristics and management in a Lebanese consultation-liaison psychiatry service.

Findings

18.8% of patients referred to the CLP service had a substance use disorder, predominantly alcohol and cannabis use.

Patients with SUDs were more likely to be male and require intubation during hospital admission.

Alcohol use disorder patients with comorbid conditions were more likely to be admitted to the ICU.

Abstract

Substance use disorders (SUDs) are a growing public health concern in the Arab world. To our knowledge, no previous study in Lebanon assessed the characteristics, management, and outcomes of patients with SUDs seen and managed by a consultation-liaisoin psychiatry (CLP) service.

This study explores the characteristics and management of individuals with SUDs who were referred to the CLP service in a tertiary care center in Lebanon.

As part of the Consultation-Liaison at the American University of Beirut (CLAUB) analysis, we conducted a retrospective record review of patients referred to our CLP service between February 2019 and May 2020. We assessed differences between SUD and non-SUD consults using Chi-square analysis, Fisher’s exact test, or Mann-Whitney U test, as appropriate.

Of 1475 patients, 278 (18.8%) received a diagnosis of SUD. They were mostly males (73.7%) with an average age of 38.8 years. The most used substances were alcohol (60%) and cannabis (28.4%). Compared to non-SUD consults, patients with SUDs were more likely to be males (odds ratio OR=3.18, p<0.001) and to get intubated during admission (OR=1.81, p=0.048). Predictors of intensive care unit admission in patients with alcohol use disorder included pulmonary or endocrinological disease, benzodiazepine use disorder, and days until CLP referral.

The results of this study highlight the high prevalence of alcohol use among individuals with SUD referred to the CLP service. Additionally, they underscore the limited treatment avenues available in this part of the world. The institution of a comprehensive CLP service is crucial to address the unmet needs of patients with SUDs who present to a general hospital setting.

None Declared