Substance use-related outpatient consultations in specialized health care: an underestimated entity.

Background: To study the occurrence and documentation of substance use related outpatient visits in specialized health care.

Methods: The diagnosis recorded in retrospective discharge data in Tampere University Hospital for 6 years was compared with the prospective data gathered from separately completed forms added during an 8-week period to every outpatient's discharge data. In this form, the relation of substance use and the actual reason for the consultation were specifically elicited.

Results: On the basis of diagnoses, retrospectively, 0.4% (6,666 of 1,555,898) of outpatient visits were caused by substance use. In the prospective part of the study, 5.6% of visits (1,401/25,014) were related to substance use. Retrospective study demonstrated 2% prevalence of substance use, whereas prospective study showed 36% substance use-related visits at the emergency room. According to the retrospective discharge data, alcohol-related organ damages were the major reason for substance use-related outpatient visits. In the prospective study, the proportion of acute traumas was most prevalent.

Conclusions: Our study indicates that substance use-related visits often remain undetected in specialized health care. Substance use-related visits were underdocumented/undetected in the emergency room. Using a simple separate form could dramatically increase the detection of substance use-related visits.