Psychiatric Comorbidities and Prognosis in Biochemically Screened Substance Using Adults: A Retrospective Emergency Department Cohort Study

Objective: This study examined demographic characteristics, psychiatric comorbidities, and short-term outcomes of substance-using adults with positive urine drug tests in an emergency department (ED) setting.
Material and Methods: Retrospective cohort of adults (≥18 years) who presented to ED between May 2022 and November 2023 with at least one positive urine test. Data included demographics, psychiatric history, ED diagnosis, disposition, hospital stay, and 1-month mortality. Urine drug screening used a standard biochemical method.
Results: Among 427 patients, the median age was 27 years, and 72.6% were male. The most frequently detected substances were amphetamines, cannabinoids, and benzodiazepines. Psychiatric disorders were identified in 59% of patients based on prior medical records. Hospitalization was more common in those with psychiatric comorbidities. Amphetamine and benzodiazepine users were more often discharged, whereas those who used cannabinoids or synthetic cannabinoids had longer hospital stays.
Conclusion: Psychiatric comorbidities are associated with increased hospitalization among substance-using adults. Substance type appears to influence clinical outcomes: stimulants and sedatives were linked to higher discharge rates, while cannabinoids were associated with prolonged hospitalizations. These findings highlight the importance of integrated psychiatric care and routine screening in EDs.

Keywords: Substance-related disorders, mental health, amphetamine, benzodiazepines