The American journal of emergency medicine · 2026
Association of loneliness and substance use among emergency department patients.
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Sacco Dana L, Anderson Quinn R, Cadet Kechna, Sichel Corianna E, Marziali Megan E, Blanchard Ashley M, Agnello Francesca, De Souza Jaciara N, Mannes Zachary L
Аннотация
BACKGROUND: Loneliness is associated with numerous adverse health outcomes. However, little is known about its relationship with substance use among emergency department (ED) patients, a population at elevated risk for substance use and related harms. We examined associations between loneliness and past 90-day substance use among ED patients.
METHODS: A convenience sample of patients aged 18-75 years was recruited from an urban academic ED between March 2025 and January 2026 (N = 300). Loneliness was assessed using the UCLA Loneliness Scale (UCLA-20; range = 20 to 80). The Tobacco, Alcohol, Prescription Medication, and Other Substance Use (TAPS) tool assessed binge alcohol use, cannabis use, and illicit drug use, including crack/cocaine, sedatives/hypnotics, opioids, and polydrug use. Multivariable logistic regression models examined associations between loneliness and substance use outcomes, adjusting for demographic characteristics, cigarette use and anxiety and depression symptoms.
RESULTS: Each one-point increase in loneliness was associated with greater odds of illicit drug use (adjusted odds ratio [aOR] = 1.07, 95% confidence interval [CI]:1.03-1.11), including use of opioids (aOR = 1.10, 95% CI:1.03-1.19), crack/cocaine (aOR = 1.06, 95% CI:1.01-1.13), and polydrug use (aOR = 1.04, 95% CI:1.01-1.08).
CONCLUSIONS: Loneliness was independently associated with recent illicit drug use. These findings suggest that loneliness may be an important and underrecognized correlate of high-risk substance use in ED populations. Incorporating loneliness assessment into ED screening workflows may help identify patients at elevated risk for substance-related harms and inform interventions aimed at improving engagement with substance use treatment and supportive services.
METHODS: A convenience sample of patients aged 18-75 years was recruited from an urban academic ED between March 2025 and January 2026 (N = 300). Loneliness was assessed using the UCLA Loneliness Scale (UCLA-20; range = 20 to 80). The Tobacco, Alcohol, Prescription Medication, and Other Substance Use (TAPS) tool assessed binge alcohol use, cannabis use, and illicit drug use, including crack/cocaine, sedatives/hypnotics, opioids, and polydrug use. Multivariable logistic regression models examined associations between loneliness and substance use outcomes, adjusting for demographic characteristics, cigarette use and anxiety and depression symptoms.
RESULTS: Each one-point increase in loneliness was associated with greater odds of illicit drug use (adjusted odds ratio [aOR] = 1.07, 95% confidence interval [CI]:1.03-1.11), including use of opioids (aOR = 1.10, 95% CI:1.03-1.19), crack/cocaine (aOR = 1.06, 95% CI:1.01-1.13), and polydrug use (aOR = 1.04, 95% CI:1.01-1.08).
CONCLUSIONS: Loneliness was independently associated with recent illicit drug use. These findings suggest that loneliness may be an important and underrecognized correlate of high-risk substance use in ED populations. Incorporating loneliness assessment into ED screening workflows may help identify patients at elevated risk for substance-related harms and inform interventions aimed at improving engagement with substance use treatment and supportive services.