Road safety threats and occupational health risk associated with psychoactive substance use and dependence risk among commercial drivers: WHO ASSIST evidence from Ghana.

To evaluate the psychometric properties of the Spanish version of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and its effectiveness as a screening tool for problematic alcohol, tobacco and other psychoactive substance use in groups of low, moderate, and high risk users. A test battery including the ASSIST and several standardized screening, assessment, and diagnostic instruments was administered to 485 patients recruited in different primary health-care facilities and specialized addiction treatment units from Health Area 11 in Madrid. ASSIST cut-off scores show a good sensitivity and specificity for discrimination between substance use and abuse and between abuse and dependence. Concurrent validity was demonstrated by significant correlations between ASSIST scores and scores from the Mini-International Neuropsychiatric Interview (MINI-Plus), the Alcohol Use Disorders Identification Test (AUDIT), the Revised Fagerstrom Tolerance Questionnaire (RTQ) and the Severity of Dependence Scale (SDS). Psychometric properties of the Spanish version of the ASSIST indicate that is a valid screening test for identifying substance use disorders in various health-care settings.

BackgroundThere is a high prevalence of psychoactive substance use among patients with mental health disorders. The optimal treatment of patients with mental health disorders requires an awareness of their history pertaining substance use. Several methods are used to assess the use of substance. Each of them embodies its limitations. This study aimed at assessing the diagnostic capability of a self-report psychoactive substance use among patients at the National Psychiatric University Hospital of Cotonou, Benin.MethodsA cross-sectional survey was conducted from August 1, 2021 to November 24, 2021. A total of 157 consenting patients admitted to psychiatric consultations were successively enrolled in the ongoing study. They were screened for the use of psychoactive substance with Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), followed by urine test using the NarcoCheck® kit for qualitative detection of substances or its metabolites. To assess the diagnostic capability, the participants’ self-responses were compared with their urine test results. The sensitivity, specificity, positive and negative predictive values, and kappa coefficient were also calculated.ResultsThe frequency of lifetime psychoactive substance use according to self-report was 81.5% (95% CI: 0.746–0.873), while over the past three months (recent use) was 52.2% (95% CI: 0.441–0.603) and 58.6% based on the urine test. Alcohol, tobacco and cannabis were the most prevalent psychoactive substance used. The overall concordance between self-reported psychoactive substance use and the urine test (gold standard) was moderate (sensitivity = 66%; kappa = 0.46). Self-report cocaine use compared with urine test showed the highest concordance (sensitivity = 100%; kappa = 79%), followed by tobacco (sensitivity = 58%, kappa = 41%). On an average 70% of urine test results were consistent with self-report (VPP). Participants’ were more accurate when they were reporting no psychoactive substance use as suggested by the high negative predictive value (NPV).ConclusionDiagnostic capability of self-reporting of psychoactive substance use among patients admitted to psychiatric consultations was moderate. Therefore self-reporting may not estimate the exact prevalence of psychoactive substance use. Optimal identification of psychoactive substances use in psychiatric patients requires both history and urine testing. The integration of these two approaches is an excellent method to find out the level, frequency and nature of drug used.

Psychoactive substance use is frequently encountered in hospitals' emergency departments (EDs). It accounts for major health-care problems frequently leading to accident and ED admissions, yet it is frequently unidentified. The aim of this study was to determine the prevalence and pattern of psychoactive substance use among patients presenting in the Accident and EDs and to compare the case detection rate of psychoactive substance use between self-report questionnaire and biochemical markers (e.g., urine toxicology). To achieve this, 200 consenting participants attending the accident and emergency unit of a tertiary hospital were consecutively enlisted into the study within 2 weeks. They were screened for psychoactive substance use with the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and the urine drug test (UDT). The lifetime prevalence of psychoactive substance use was 45.5%, while the past 3 months (recent use) prevalence was 27.0%. The pattern of psychoactive substance use revealed that alcohol was the predominant psychoactive substance use with a lifetime prevalence of 13.0% and recent use of 12.0%. The UDT significantly detected more patients who used psychoactive substance compared to self-report (P < 0.001). The prevalence of drug use recorded among attendees of the accident and emergency unit was high in this study. The UDT significantly detected more patients who used psychoactive substances compared to self-report (P < 0.001). Several patients with major health problems as a result of psychoactive substance use were identified with the aid of these screening tools.

The concurrent, construct and discriminative validity of the World Health Organization's Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) were examined in a multi-site international study. One thousand and 47 participants, recruited from drug treatment (n = 350) and primary health care (PHC) settings (n = 697), were administered a battery of instruments. Measures included the ASSIST; the Addiction Severity Index-Lite (ASI-Lite); the Severity of Dependence Scale (SDS); the MINI International Neuropsychiatric Interview (MINI-Plus); the Rating of Injection Site Condition (RISC); the Drug Abuse Screening Test (DAST); the Alcohol Use Disorders Identification Test (AUDIT); the Revised Fagerstrom Tolerance Questionnaire (RTQ); and the Maudsley Addiction Profile (MAP). Concurrent validity was demonstrated by significant correlations between ASSIST scores and scores from the ASI-Lite (r = 0.76-0.88), SDS (r = 0.59), AUDIT (r = 0.82) and RTQ (r = 0.78); and significantly greater ASSIST scores for those with MINI-Plus diagnoses of abuse or dependence (P < 0.001). Construct validity was established by significant correlations between ASSIST scores and measures of risk factors for the development of drug and alcohol problems (r = 0.48-0.76). Discriminative validity was established by the capacity of the ASSIST to discriminate between substance use, abuse and dependence. Receiver operating characteristic (ROC) analysis was used to establish cut-off scores with suitable specificities (50-96%) and sensitivities (54-97%) for most substances. The findings demonstrated that the ASSIST is a valid screening test for identifying psychoactive substance use in individuals who use a number of substances and have varying degrees of substance use.

The assessment of mood disorders and addiction linked to the practice of chemsex is of interest given the psychoactive substances used. The aim of this study was to assess risky sexual and addictive behavior to chemsex and related anxiety/depression symptoms in individuals receiving HIV pre-exposure prophylaxis (PrEP). In this cross-sectional study, all adults presenting for PrEP renewal at French sexual health centers were enrolled from January 2018 to March 2019. Participants completed a questionnaire on chemsex (i.e., the use of psychoactive substances before/during sex), including adapted Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) to chemsex addiction (questions of ASSIST were modified to focus on chemsex). Anxiety/depression was assessed with the Hospital Anxiety and Depression Scale. In the last 3 months before enrollment, 39.8% (94/236) of participants reported chemsex. The main psychoactive substances consumed during chemsex were cathinones (74.6%), gamma-hydroxybutyrate (66.3%), and other psychostimulants (60%). The median score of the chemsex-focused ASSIST was 8 [IQR25-75 : 3-15]; 72.2% of participants had a score justifying at least a brief intervention (>4). In multivariate analyses, anxiety and cathinones consumption were associated with an ASSIST score >4: OR 13.65 (95% CI 1.68-662.7), P = 0.0062, and OR 8.468 (95% CI 2.066-43.059), P = 0.0014, respectively. The level of addiction to the practice of chemsex can be difficult to estimate for the user, and the ASSIST makes it possible to evaluate this addiction and to direct the subjects toward specialized consultations of addictology, sexual health, or PrEP renewals. The implementation of the modified ASSIST in these consultations can allow early systematic screening and counseling.

Objective: Describe the profile of the HIV/AIDS patients who use psychoactive substances; relate the use of psychoactive substances and Antiretroviral Therapy (ART) to non-adherence; and identify the main barriers for non-adherence. Methods: A cross-sectional study in a population of HIV/AIDS patients under ART prescription. Non-adherence to ART was considered when the patients presented a viral load higher than 40 copies per mL. The use of psychoactive substances was evaluated by Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Results: From 320 HIV/AIDS patients analyzed, 18.8% were not adhering to ART, 25.8% used alcohol, 21.7% smoked and 29.7% used some illicit psychoactive substance. The barriers were: high number of pills to be taken; fear that other people may know they are sick; difficulty of taking so many pills (if they do not feel sick); and they do not believe in the efficacy of the treatment (would rather try alternative treatments). Conclusion: Patients under higher risk are not white and young, from lower social classes, and use psychoactive substances. Strategies should focus on the promotion of adherence considering the barriers reported.

Background: World Health Organization developed the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) as the first screening test for rapidly detecting the harmful use of all major psychoactive substances. However, epidemiological research on substance use screening using ASSIST in Indian populations is limited. Aims and Objectives: To screen for harmful alcohol use in the Indian workplace settings using ASSIST. Subjects and Methods: In this cross-sectional study, 162 class C employees were randomly screened in their workplace settings from a tertiary care hospital based on the criteria of ASSIST. Results: The study found that nearly one-fourth (24.06%, n = 39) of the total participants as moderate and high-risk users of alcohol as per ASSIST scores. In addition, one-fifth (19.74%, n = 32) of the total participants used both alcohol and tobacco in moderate or high-risk manner. Conclusion: The results of the study indicate the alarming magnitude of harmful alcohol use in workplace settings and advocate that ASSIST is an important screening tool for detecting harmful substance use in this population.

The concurrent, construct, discriminative and predictive validity of the World Health Organization's Alcohol Substance Involvement Screening Test (ASSIST) were examined in an Australian sample. One hundred and fifty participants, recruited from drug treatment (n = 50) and primary health care (PHC) settings (n = 100), were administered a battery of instruments at baseline and a modified battery at 3 months. Measures included the ASSIST; the Addiction Severity Index-Lite (ASI-Lite); the Severity of Dependence Scale (SDS); the MINI International Neuropsychiatric Interview (MINI-Plus); the Rating of Injection Site Condition (RISC); the Drug Abuse Screening Test (DAST); the Alcohol Use Disorders Identification Test (AUDIT); the Revised Fagerstrom Tolerance Questionnaire (RTQ); and the Maudsely Addiction Profile (MAP). Concurrent validity was demonstrated by significant correlations between ASSIST scores and scores from the ASI-lite, SDS, AUDIT and DAST; and significantly greater ASSIST scores for those with diagnoses of abuse or dependence. Construct validity was established by significant correlations between ASSIST scores and measures of risk factors for the development of drug and alcohol problems. Participants diagnosed with attention deficit/hyperactivity disorder or antisocial personality disorder had significantly higher ASSIST scores than those not diagnosed as such. Discriminative validity was established by the capacity of the ASSIST to discriminate between substance use, abuse and dependence. ROC analysis was able to establish cut-off scores for an Australian sample, with suitable specificities and sensitivities for most substances. Predictive validity was demonstrated by similarity in ASSIST scores obtained at baseline and at follow-up. The findings demonstrated that the ASSIST is a valid screening test for psychoactive substance use in individuals who use a number of substances and have varying degrees of substance use.

<i>Background:</i> The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) was developed to detect substance use disorders. <i>Aims:</i> The objective of the present study was to evaluate the psychometric properties of the French version of ASSIST in various clinical groups with different levels of substance use. <i>Methods:</i> 150 subjects were recruited from clients attending primary health care, psychiatric and addiction treatment facilities. Measures included ASSIST, Addiction Severity Index (ASI), Mini-International Neuropsychiatric Interview (MINI-Plus), Alcohol Use Disorders Identification Test (AUDIT) and Revised Fagerstrom Tolerance Questionnaire-Smoking (RTQ). <i>Results and Conclusion:</i> Concurrent validity was demonstrated by significant correlations between ASSIST scores and scores from ASI, AUDIT and RTQ, as well as significantly greater ASSIST scores for patients with a MINI-Plus diagnosis of abuse or dependence. The ASSIST questionnaire was found to have high internal consistency for the total substance involvement as well as for specific substance involvement as assessed with Cronbach’s α, ranging from 0.74 to 0.93. When possibly computed, ASSIST cutoff scores have interesting sensitivity and specificity for discrimination between use and abuse and between abuse and dependence. The findings demonstrated that the French version of ASSIST is a valid screening test for identifying substance use disorders in various health care settings, including psychiatric settings.

The World Health Organization's Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) has strong support as a clinical screening tool and research instrument, but has only been validated with adults. This study evaluated the ASSIST and ASSIST-Lite in an adolescent population. Internal consistency, concurrent validity, discriminant validity and diagnostic accuracy were examined for tobacco, alcohol and cannabis ASSIST scores. An abbreviated version (the ASSIST-Lite) was evaluated for cannabis. Three community health centers in Baltimore, MD, USA. A total of 525 primary care patients, ages 12-17 years. Measures included the ASSIST, the CRAFFT screening tool and items from the Composite International Diagnostic Interview (CIDI) corresponding to substance use disorder criteria in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. The ASSIST had good internal consistency (α = 0.68-0.88), good concurrent validity with the CRAFFT (r = 0.41-0.76; P < 0.001), and was able to discriminate between gradations of cannabis problem severity. In receiver operating characteristics analysis of optimal clinical cut-points, the ASSIST accurately identified tobacco, alcohol and cannabis use disorders (sensitivities = 95-100%; specificities = 79-93%; area under the curve [AUC] = 0.90-0.94), but did so at minimally low cut-points (indicative of any use in the past 3 months). The ASSIST-Lite performed similarly to the ASSIST in identifying cannabis use disorders (sensitivity = 96%; specificity = 88%; AUC = 0.92), also at a minimally low cut-point. However, confirmatory factor analysis of the ASSIST indicated poor model fit. The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) is promising as a research and screening/brief assessment tool with adolescents, but revisions to clinical risk thresholds are warranted. The ASSIST-Lite is sufficiently informative for rapid clinical screening of adolescents for cannabis use disorders.

Background: The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) was developed to detect substance use disorders. Aims: The objective of the present study was to evaluate the psychometric properties of the French version of ASSIST in various clinical groups with different levels of substance use. Methods: 150 subjects were recruited from clients attending primary health care, psychiatric and addiction treatment facilities. Measures included ASSIST, Addiction Severity Index (ASI), Mini-International Neuropsychiatric Interview (MINI-Plus), Alcohol Use Disorders Identification Test (AUDIT) and Revised Fagerstrom Tolerance Questionnaire-Smoking (RTQ). Results and Conclusion: Concurrent validity was demonstrated by significant correlations between ASSIST scores and scores from ASI, AUDIT and RTQ, as well as significantly greater ASSIST scores for patients with a MINI-Plus diagnosis of abuse or dependence. The ASSIST questionnaire was found to have high internal consistency for the total substance involvement as well as for specific substance involvement as assessed with Cronbach’s α, ranging from 0.74 to 0.93. When possibly computed, ASSIST cutoff scores have interesting sensitivity and specificity for discrimination between use and abuse and between abuse and dependence. The findings demonstrated that the French version of ASSIST is a valid screening test for identifying substance use disorders in various health care settings, including psychiatric settings.

The COVID-19 pandemic has created a psychoactive substance use crisis in many countries, including México. Remote valid tools to identify high-risk groups in need for treatment are a prerequisite for cost-effective interventions in primary care settings. To determine the validity and correlates of the remote applications of the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) with sex, age, and psychological care-seeking, offered remotely in primary settings, during the COVID-19 pandemic in Mexico, a total sample of 19,109 Mexicans, with an average age of 34.38 years (SD = 12.28, range = 18–80), 65.8% of whom were women (n = 12,578), 29.6% in lockdown (5,660), 39.8% in partial lockdown (7,611), 30.60% not in lockdown (5,838), and 14.75% of whom were seeking psychological care (n = 2,819), completed ASSIST through a programmed Web application. The dimensionality of the scale to verify construct validity evidence was achieved through a confirmatory factor analysis model (CFA). We represented the distribution of subjects by sex, age, lockdown condition, and psychological care-seeking, based on their lifetime consumption in 2021. We also compared the total distribution by consumption risk level and recommended type of intervention, psychological care-seeking, and age. The tool included ten dimensions (one for each substance, such as tobacco use), confirmed through the CFA. In general, our findings indicated that men reported high lifetime psychoactive substance use and risky drug use levels. A high percentage of 18 to 19-year-old women reported lifetime tobacco and alcohol use. Additionally, a high number of all-age women reported lifetime sedative and opioid use. Also, a high proportion of partially lockdown participants reported lifetime drug use. Moreover, a high percentage of subjects seeking psychological care were at a moderate and high risk of drug use, which required brief or intensive treatment. Our findings indicate that it was possible to validate the factor structure of the programmed ASSIST for remote use. More men than women reported high lifetime psychoactive substance use and risky levels because of their consumption. At the same time, younger women reported similar and even higher lifetime tobacco, alcohol, and cocaine use than same-age men. More all-age women reported lifetime use of sedatives than all-age men. More all-age partially lockdown participants reported lifetime use of drugs. In general, subjects at greater risk and those requiring psychological care are more likely to seek care. Community and primary care screening will make it possible to implement effective early interventions to reduce the substance use risks associated with health emergencies. Future studies are required to determine the diagnosis of substance use disorders to evaluate the cut-off points in the screening test to discriminate between the presence and absence of symptoms and evaluate the effect of remote psychological care.

Reliability of online self-report versions of the Australian Treatment Outcome Profile (ATOP) and Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) among people in residential treatment for substance use problems

To address barriers to implementing the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in medical settings, we adapted the traditional interviewer-administered (IA) ASSIST to an audio-guided computer assisted self-interview (ACASI) format. This study sought to validate the ACASI ASSIST by estimating the concordance, correlation and agreement of scores generated using the ACASI versus the reference standard IA ASSIST. Secondary aims were to assess feasibility and compare ASSIST self-report to drug testing results. Participants completed the ACASI and IA ASSIST in a randomly assigned order, followed by drug testing. Urban safety-net primary care clinic in New York City, USA. A total of 393 adult patients. Scores generated by the ACASI and IA ASSIST; drug testing results from saliva and hair samples. Concordance between the ACASI and IA ASSIST in identifying moderate-high-risk use was 92-99% for each substance class. Correlation was excellent for global scores [intraclass correlation (ICC) = 0.937, confidence interval (CI) = 0.924-0.948] and for substance-specific scores for tobacco (ICC = 0.927, CI = 0.912-0.940), alcohol (ICC = 0.912, CI = 0.893-0.927) and illicit drugs (ICC = 0.854, CI = 0.854-0.900) and good for prescription drugs (ICC = 0.676, CI = 0.613-0.729). Ninety-four per cent of differences in global scores fell within anticipated limits of agreement. Among participants with a positive saliva test, 74% self-reported use on the ACASI ASSIST. The ACASI ASSIST required a median time of 3.7 minutes (range 0.7-15.4), and 21 (5.3%) participants requested assistance. The computer self-administered Alcohol, Smoking and Substance Involvement Screening Test appears to be a valid alternative to the interviewer-administered approach for identifying substance use in primary care patients.

The reliability and validity of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in first-episode psychosis