Baseline medical comorbidities in adults randomized in the STRIDE trial for psychostimulant use disorders.
Rates of medical illnesses may be higher among individuals with substance use disorders, complicating their care. This study aimed to expand the understanding of other medical conditions in treatment-seeking adults with stimulant use disorder (SUD) using data from the NIDA Clinical Trials Network study Stimulant Reduction Intervention using Dosed Exercise (STRIDE), a randomized, multisite trial investigating exercise augmentation of treatment as usual.
The analysis examined demographic and clinical characteristics based on the number of self-reported diagnosed medical conditions among participants meeting eligibility criteria (passing medical screening exam and maximal exercise test, non-opioid dependent, no concomitant beta blocker, or opioid replacement therapy). The majority (59%) of study participants (N=302, mean age of all participants: 39 years) did not report any history of other medical problems. Those with two or more conditions were older (mean age 46 years), reported more pain and worse physical functioning, and more psychiatric disorders (average 1.44). Hypertension was more common among participants with cocaine use disorders only (present in 16%) and liver disease was more common in those with cocaine plus other stimulant use disorders (present in 7%).
Conclusions: Despite widely held beliefs that adults with SUD face a heavy burden of physical illness, the majority of STRIDE study participants reported no other medical conditions (though the study sample excluded patients with a serious medical condition that prevented exercise, and therefore may be less representative of the general population of those with SUD). A subpopulation had an overall higher burden of illness with worsened physical and psychiatric functioning. Provision of coordinated care may optimize treatment outcomes for patients based on medical comorbidity burden as well as type of drug abused, although these conclusions should be considered preliminary as they are based on self-reported data.
Related protocols: CTN-0037