Substance use, risk of dependence, counseling and treatment among adult health center patients.

Health centers provide primary care to 20 million underserved patients. We examined the prevalence of substance use and risk of dependence among health center patients, and identified factors associated with desire for counseling/treatment and discussions about substance use with a doctor. National data on 3,949 adults came from the 2009 Health Center Patient Survey. Forty percent of patients reported past-year binge drinking, 14% of patients had used any drug in the past three months, and 13% of these recent users were at high risk of dependence. Eighty-four percent of patients who desired substance use counseling or treatment reported receiving it. Several factors were associated with patients discussing substance use with their doctors (e.g., younger age, being male, severe mental illness, current smoking). Patients most likely to desire substance use counseling or treatment were male, unmarried, insured, current smokers, and indicated mental health problems.