Prevalence of substance use in a Dutch migraine population

Abstract text (incl. figure legends and references)

Objective: Tobacco, alcohol, and illicit substance use result in substantial morbidity and mortality. Moreover, there is controversy concerning their ability to increase susceptibility to migraine attacks. The current study sought to examine the prevalence of substance use in a large migraine cohort. Prevalence was compared to the general population.

Methods: Data on substance use were collected by survey in a large migraine cohort¹ and from the annual health survey for substances in the general Dutch population (Statistics Netherlands 2016/2017). Associations for substance consumption were standardized for sex, age and educational level and analyzed using chi-square.

Results: From the Leiden Headache Center, a standardization a total of 4993 patients with migraine were included. Differences were found between migraine and the general population for illicit drug use (OR 0.53, 95%CI 0.45-0.63, p<0.01), current smoking (OR 0.52, 95%CI 0.47-0.57, p<0.01), life-time smoking (OR 0.52, 95%CI 0.48-0.55, p<0.01) and current alcohol consumption (OR 0.44, 95%CI 0.40 – 0.47, p<0.01). Prevalences for the use of illicit drugs, current smoking, life-time smoking and current alcohol consumption are shown in figure 1.

Conclusion: Individuals with migraine are less likely to smoke, drink alcohol or use illicit drugs compared to the general population. Migraine patients might avoid alcohol due to presumed trigger effects.² Differences in smoking prevalence might be due to an increased awareness of an elevated cardiovascular risk among migraine patients.

References

¹ Oosterhout et al Cephalalgia. 2011 Oct;31(13):1359-67

² Onderwater et al Eur J Neurol. 2019;26:588-95

Figure 1. Substance use for Dutch General population and migraine patients after standardization adjusting for age, sex and education.