Addiction Severity Index Scores Research Articles

Assessing emotional intelligence domains and levels in substance use disorders

BackgroundMany individuals with substance use disorders face challenges in their social interactions and often have strained relationships with peers. Challenges related to problem-solving, stress management, and impulsivity often contribute to their substance use disorders. Emotional intelligence plays a pivotal role in assisting individuals with substance use disorders in coping with stress, enhancing peer connections, resolving problems, and preventing relapse. Consequently, our study aimed to assess emotional intelligence in individuals with substance use disorders and explore the factors influencing it. A cross-sectional study compared 50 individuals with substance use disorders and 50 healthy individuals. We assessed various factors, including clinical data, sociodemographic variables, family socioeconomic status, Addiction Severity Index (ASI) scores, and Emotional Intelligence (EI) scale scores.ResultsIndividuals with substance use disorders had significantly lower mean scores in total EI and its subscales compared to the healthy control group. Additionally, a higher percentage of individuals with substance use disorders exhibited low EI levels, while healthy individuals demonstrated better EI. Furthermore, there was a substantial association between higher ASI scores in individuals with substance use disorders and lower EI scores.ConclusionsLower EI scores are associated with an increased risk of substance use disorders. Also, can contribute to difficulties in impulse control, and challenges in managing relationships and stress. These findings underscore EI crucial role in preventing and treating substance use disorders.

Addiction severity and re-employment in Sweden among adults with risky alcohol and drug use

BackgroundThe Addiction Severity Index (ASI) assesses respondents' biopsychosocial problems in seven addiction-related domains (mental health, family and social relations, employment, alcohol use, drug use, physical health, and legal problems). This study examined the association between the seven ASI composite scores and re-employment in a sample of Swedish adults screened for risky alcohol and drug use who were without employment at assessment. MethodsWe conducted a retrospective cohort analysis of employment outcomes among 6502 unemployed adults living in Sweden who completed an ASI assessment for risky alcohol and drug use. The study linked ASI scores to annual tax register data. The primary outcome was employment, defined as having earnings above an administrative threshold. We used Cox proportional hazard models to estimate the association between time to re-employment and ASI composite scores, controlling for demographic characteristics, ResultsApproximately three in ten individuals in the sample regained employment within five years. ASI composite scores suggested widespread biopsychosocial problems. Re-employment was associated with lower ASI composite scores for mental health (estimate: 0.775, 95 % confidence interval: 0.629–0.956), employment (estimate: 0.669, confidence interval: 0.532–0.841), drug use (estimate: 0.628, confidence interval: 0.428–0.924), and health (estimate: 0.798, confidence interval: 0.699–0.912). ConclusionsThis study suggests that several ASI domains may provide information on the complex factors (i.e., mental health, health, drug use) associated with long-term unemployment for people with risky substance use.

No evidence of accelerated epigenetic aging among black heroin users: A case vs control analysis

This study sought to assess the association between illicit opioid use and accelerated epigenetic aging (A.K.A. DNAm Age) among people of African ancestry who use heroin. DNA was obtained from participants with opioid use disorder (OUD) who confirmed heroin as their primary drug of choice. Clinical inventories of drug use included: the Addiction Severity Index (ASI) Drug-Composite Score (range: 0–1), and Drug Abuse Screening Test (DAST-10; range: 0–10). A control group of participants of African ancestry who did not use heroin was recruited and matched to heroin users on sex, age, socioeconomic level, and smoking status. Methylation data were assessed in an epigenetic clock to determined and compare Epigenetic Age to Chronological Age (i.e., age acceleration or deceleration). Data were obtained from 32 controls [mean age 36.3 (±7.5) years] and 64 heroin users [mean age 48.1 (±6.6) years]. The experimental group used heroin for an average of 18.1 (±10.6) years, reported use of 6.4 (±6.1) bags of heroin/day, with a mean DAST-10 score of 7.0 (±2.6) and ASI Score of 0.33 (±0.19). Mean age acceleration for heroin users [+0.56 (± 9.5) years] was significantly (p< 0.05) lower than controls [+5.19 (± 9.1) years]. This study did not find evidence that heroin use causes epigenetic age acceleration.

The impact of psychiatric disorders of parents on the severity of substance use disorder in their offspring

Introduction There is a lack of evidence in the literature about the impact of offspring addiction and their parents’ mental health. Objective is to explore psychiatric disorders in parents of patients with substance dependence and their effect on the severity of their addiction.ObjectivesTo evaluate psychiatric disorders in parents of patients with substance dependence and their effect on the severity of their addiction.MethodsThis is a cross sectional study contained group (A) 150 patients diagnosed with substance dependence according to DSM-IV. Patients were recruited form Psychiatry and Addiction Hospital of Cairo University. Group (B) included one or both parents of the patients group. The Addiction Severity Index (ASI) was used for the patients.ResultsIn the patients group, mean age was 24.89 (±4.52). 96% of them were males 4% were females. In the parent group, mean age was 51.59 (±5.48). 84% of them were mothers 16 % were females. Patients group was associated with moderate degree of education (46.7%), 73.3% were single and 64% were unemployed. Anxiety disorders (80%) and depressive disorders (69.3%) were the most prevalent among parents group. ASI score was statistically significant in predicting the incidence of parents psychotic and schizoid disorders (100% sensitivity, 86.3% specificity, AUC=0.887, P value &lt;0.0001).Besides we found a significant correlation between patients ASI scores and parents psychiatric disorder.ConclusionsThis result emphasizes the relation between patient substance use disorder and psychiatric disorder of their parents. Patients ASI score may be a possible measure for parents mental disorder. Further research is needed to validate our findings.DisclosureNo significant relationships.

Drug-related problems among polysubstance and monosubstance users: a cross-sectional study

ABSTRACT Objective: The objective of this study was to estimate the prevalence as well as the sociodemographic and clinical correlates among patients diagnosed with polysubstance use who sought treatment in comparison to monosubstance users. Design and Methods: This is a cross-sectional study which included 100 patients diagnosed with SUDs based on the DSM-IV-TR criteria who sought treatment. The said patients were assessed using structured clinical interview for DSM-IV Axis I disorders (SCID-I) and DSM-IV Axis II disorders (SCID-II), in addition to urine screen for drugs. Furthermore, the addiction severity index (ASI) was employed to assess drug-related problems in these patients. Results: The results show that 46% of the SUDs patients demonstrate polysubstance use, which primarily includes tramadol (92%), cannabis (86%) and alcohol (59%). Polysubstance users are more likely to be males, skilled workers and smokers compared to monosubstance users. Moreover, polysubstance use is associated with alcohol, drug, legal and psychiatric problems based on the ASI scores in comparison to monosubstance use. Additionally, polysubstance patients are two times more likely to suffer from antisocial personality disorders (ASPD) than monosubstance patients (24% in contrast to 9%). Conclusions: Polysubstance use is associated with the male gender, employment, smoking, ASPD and drug-related problems.

Age at first drink and severity of alcohol dependence

BackgroundEarly age at first drink (AFD) has been linked to early onset and increased severity of alcohol dependence in various studies. Few Indian studies on AFD have shown a negative correlation between AFD and severity of alcohol dependence. Our study aimed to explore this relationship in patients with alcohol dependence syndrome (ADS) diagnosed using ICD-10 criteria. MethodsOne hundred fifty-one consecutive patients freshly diagnosed with ADS were included in the study, which was conducted at the psychiatry unit of a tertiary care, multispecialty hospital. The Addiction Severity Index (ASI) was used to assess severity of alcohol dependence. ResultsMean AFD was 24.85 years (range = 13–40 years). Median ASI score was 36 (range = 21 to 57). The study yielded a weak negative correlation (ρ = −.105) between AFD and ASI, which was statistically not significant. ConclusionsWe found no correlation between AFD and severity of alcohol dependence at detection in Indian Armed Forces personnel, which is contrary to what has been reported worldwide and in previous Indian studies. Delayed initiation of alcohol use among those enrolling in the Indian Armed Forces and early detection of alcohol dependence within the military environment are possible explanations.

Personality variables modify the relationship between childhood maltreatment history and poor functional outcomes

Childhood maltreatment history is a prevalent risk factor for substance use disorder and has lifelong adverse consequences on psychiatric wellbeing. The role of personality variations in determining childhood maltreatment-associated outcomes is poorly understood. This study sought to test neuroticism and agreeableness as mediator and moderator, respectively, of functional outcomes associated with having a history of childhood maltreatment and presence/absence of cocaine dependence. Ninety-four participants completed the Structured Clinical Interview for DSM-IV (SCID-IV), Childhood Trauma Questionnaire (CTQ), NEO-Five Factor Inventory (NEO-FFI), and the Addiction Severity Index (ASI). The distribution-of-the-product strategy tested if neuroticism mediated the relationship between CTQ and ASI scores. Agreeableness was tested as a moderator using bootstrapped multiple regression analyses with agreeableness*CTQ interaction terms as predictors of ASI scores. Analyses covaried for cocaine dependence to determine its influence. Neuroticism mediated the relationship between severity of childhood maltreatment history and family (ASI-Family) and psychiatric (ASI-Psychiatric) dysfunction in adulthood, independent of cocaine dependence. Agreeableness negatively moderated the effect of childhood maltreatment severity on family dysfunction. Exposure to emotional neglect and abuse selectively drove the mediation and moderation effects. Personality-directed interventions that reduce neuroticism or increase agreeableness may be promising approaches to uncouple childhood maltreatment history from lifelong social and psychiatric dysfunction.

Seeking Safety Therapy for Co-Occurring Posttraumatic Stress Disorder and Substance Use Disorder: A Case Study in Iran

Background: Literature documents the high prevalence of trauma and posttraumatic stress disorder (OTSD) in individuals with substance use disorders, which complicate the clinical profile of patients and present challenges for treatment providers. Although several evidence-based integrated therapies are developed for comorbid PTSD/SUD (substance use disorder), there is a considerable gap addressing this co-occurrence and none of such practices are studied yet on such patients. Through A-B-A single subject design. Objectives: The current study aimed to explore the effectiveness of seeking safety (SS), an integrative evidence-based therapy for PTSD/SUD, to reduce PTSD and SUD symptoms in a 32-year-old female with both disorders. Patients and Methods: Measures of PTSD checklist (PTSD ChecklistCivilian; PCL-C), Addiction Severity Index (ASI), Brief Symptom Inventory (BSI), and Coping Inventory for Stressful Situations (CISS-21) were completed by the participant at baseline, intervention, and 2-month follow-up. Results: Results were analyzed through visual analysis and computing 3 effect size indices including standardized mean difference (SMD), mean baseline reduction (MBLR), and percent of non-overlapping data (PND). Conclusions: Clinically significant reductions in PTSD symptoms, psychological distress, and ASI scores, as well as improvement in coping skills were observed at intervention phase and maintained at 2-month follow-up, which indicated that the participant benefited from SS. © 2018, International Journal of High Risk Behaviors and Addiction.

Racial and Ethnic Differences in Factors Related to Drug Use Among Adult Female Offenders: Implications for Treatment

ABSTRACTThe present study examined racial and ethnic differences and relationships concerning drug use and distribution. A sample of 225 female offenders equally divided by race (Caucasian, African American, and Hispanic) completed the Addiction Severity Index (ASI; Alterman et al., 2001) and provided history and types of drug-related offenses aside from demographic information. Results revealed that Caucasians had significantly more present possession offenses than did African Americans or Hispanics. However, Hispanics had more present distribution offenses than did African Americans or Caucasians. Moreover, Caucasians had significantly higher Drug Addiction Severity Index scores than did African Americans or Hispanics. This study offers insight into the role that race, ethnicity, and gender play related to drug abuse and criminal offending.

Prevalence and Predictors of Mental/Emotional Distress Among HIV+ Jail Detainees at Enrollment in an Observational Study.

This study evaluates the prevalence of mental/emotional distress and its specific correlates among people living with HIV/AIDS (PLWHA) in 20 jail systems across the United States. Of the 878 PLWHA jail detainees, 52% had high levels of mental/emotional distress, defined by the composite Addiction Severity Index score. High mental/emotional distress was found to be associated with the inmate living in a city with lower income inequality, lower health ranking, and higher degree of danger. Proximate variables included being female, bisexual orientation, poorer physical health, and increased severity of substance abuse. Inmates in jails with accredited health services and those satisfied with family support had lower mental/emotional distress scores. These findings indicate the need for expanded mental health assessment of PLWHAs entering jail.

Geographic accessibility to addiction, mental health, and HIV/AIDS health-care services for opioid-dependent clients

Background Access to care is an important concept in health policy and health services research, yet it is one which has not been defined precisely. To some researchers “access” refers to entry into or use of a health-care system, while to others it characterizes factors influencing entry or use. [1] This paper studied accessibility as it refers to entry into or use of a health-care system by measuring geographic accessibility from the location of clients (opioid-dependent individuals) to preventive and treatment facilities for substance use disorders (SUDs), mental health, and HIV/AIDS. Materials and methods The study population is opioid-dependent clients (N = 530) screened for an ongoing study of opioid substitution therapy (OST) in Washington, DC. There were three major methodological steps. First, the study geocoded and mapped the spatial distribution of clients’ self-reported neighborhood of residence (algorithmically moved to a nearby location to protect privacy) and health-care facilities specific to their addiction and comorbidities. The facilities included centers for prevention, OST (buprenorphine and methadone), and recovery from SUDs, mental health, STI clinics and HIV/AIDS, harm reduction sites (needle exchanges), and community support (counseling centers, AA, and NA meetings). Second, the study used geostatistical methods to measure accessibility (distance and travel time) from the location of clients to the health-care facilities. Third, the study constructed Addiction Severity Index scores using client questionnaires to measure correlations between opioid users and treatment services. Results The majority of the opioid-dependent clients were located in the south-central and southern parts of the District, with significantly higher concentration in the southeast. On the other hand, the preventive and treatment centers for SUDs and mental health issues were concentrated in the south-central region with fewer substance abuse services, OST providers (Figure 1), mental health services, and AIDS drug assistance program-affiliated pharmacies in the southeast. Furthermore, there was only one site for needle exchange in this area. The results indicate that health care services needed by opioid-dependent clients with their comorbidities are not geographically accessible to those clients.

Reliability and Validity of the Turkish Version of the Addiction Severity Index in Male Alcohol Dependents.

We aimed to evaluate the psychometric characteristics of the Turkish translation of the Addiction Severity Index (ASI) in 115 male alcohol-dependent patients. The reliability of the instrument was assessed by measuring test-retest, interrater and internal reliabilities. In the validity analysis, the correlation coefficients between corresponding severity ratings and composite scores of each subscale and concurrent validity were assessed. Moreover, the discriminant validity and concurrent validity scores were calculated. The test-retest reliability of the ASI scores ranged from .79 to .91. The interrater reliability assigned by three raters was high (.74 to .99). Cronbach's alpha coefficient for internal consistency was .85 for all scales, and it varied between .64 and .77 for the subscales. The Beck Depression Inventory moderately correlated with the Psychatric status, and the MacAndrew Alcoholism Scale correlated with the Alcohol and Drug Use subscales of the Addiction Severity Index (ASI). The correlation coefficient was .91 for the alcohol use subscale. The results obtained in this study suggest that the Turkish version of the ASI could be used as a reliable and valid instrument in alcohol-dependent patients.

Addiction Severity Index Scores and Urine Drug Screens at Baseline as Predictors of Graduation From Drug Court

Graduation rates from drug courts are impressive and are often attributed to the delivered treatments. However, it is unclear whether graduation rates are bolstered by low severity of drug use problems upon entry into drug court. To address this question, this study examined the relationship between baseline substance use severity and graduation rates among 251 drug court clients. Results revealed that participants with subthreshold drug composite scores on the Addiction Severity Index (ASI) were significantly more likely to graduate than those scoring in the mild-to-moderate or severe range. Furthermore, results revealed that participants who provided a drug-negative baseline urine were significantly more likely to graduate than those who provided a drug-positive baseline urine. A binary logistic regression analysis revealed that ASI drug composite score, urine screen, race, and years educated were statistically significant predictors of drug court graduation.

Frequent Emergency Department Use Among Released Prisoners With Human Immunodeficiency Virus: Characterization Including a Novel Multimorbidity Index

The objective was to characterize the medical, social, and psychiatric correlates of frequent emergency department (ED) use among released prisoners with human immunodeficiency virus (HIV). Data on all ED visits by 151 released prisoners with HIV on antiretroviral therapy (ART) were prospectively collected for 12 months. Correlates of frequent ED use, defined as having two or more ED visits postrelease, were described using univariate and multivariate models and generated medical, psychiatric, and social multimorbidity indices. Forty-four (29%) of the 151 participants were defined as frequent ED users, accounting for 81% of the 227 ED visits. Frequent ED users were more likely than infrequent or nonusers to be female; have chronic medical illnesses that included seizures, asthma, and migraines; and have worse physical health-related quality of life (HRQoL). In multivariate Poisson regression models, frequent ED use was associated with lower physical HRQoL (odds ratio [OR] = 0.95, p = 0.02) and having not had prerelease discharge planning (OR = 3.16, p = 0.04). Frequent ED use was positively correlated with increasing psychiatric multimorbidity index values. Among released prisoners with HIV, frequent ED use is driven primarily by extensive comorbid medical and psychiatric illness. Frequent ED users were also less likely to have received prerelease discharge planning, suggesting missed opportunities for seamless linkages to care.

Comparison of the Addiction Severity Index (ASI) and the Global Appraisal of Individual Needs (GAIN) in Predicting the Effectiveness of Drug Treatment Programs for Pregnant and Postpartum Women

This study conducts a within-subject comparison of the Addiction Severity Index (ASI) and the Global Appraisal of Individual Needs (GAIN) to assess change in alcohol and other drug treatment outcomes for pregnant and postpartum women. Data are from 139 women who were pregnant or who had children under 11 months old and were admitted to residential drug treatment, then re-interviewed 6 months postdischarge (83% follow-up rate). The ASI and GAIN change measures were compared on their ability to detect changes in alcohol and drug use, medical and HIV risk issues, employment issues, legal problems, family and recovery environment characteristics, and psychological/emotional issues. The measures were similar in their ability to detect treatment outcomes, and ASI and GAIN change scores were moderately correlated with each other. The GAIN scales had equal or slightly higher coefficient alpha values than the ASI composite scores. The GAIN also includes an HIV risk scale, which is particularly important for pregnant and postpartum women. These results suggest that the GAIN is comparable with the ASI and can be used for treatment research with pregnant and postpartum women.

Chronic pain, Addiction severity, and misuse of opioids in Cumberland County, Maine

Background Few studies have examined the relationship between chronic pain and opioid abuse in non-clinical populations. We sought to investigate this in a street-recruited sample of active opioid abusers in Cumberland County, Maine, USA, a locale that had experienced substantial increases in opioid abuse. Methods A community-based sample was recruited using respondent-driven sampling. Participants were screened to identify those who had consumed illicit opioids in the prior month and administered a structured survey that included the Addiction Severity Index (ASI) and Brief Pain Inventory® (BPI). Results More than 40% of the 237 individuals reported recurring pain that interfered with daily living. For more than three-quarters of those reporting chronic pain, opioid misuse preceded the onset of chronic pain. The order of onset was not associated with differences in sociodemographic, current levels of drug misuse, or ASI and BPI scores. BPI scores were associated with medical and psychological ASI domains. Compared to those not reporting chronic pain, those doing so were more likely to have a regular physician but were more likely to report difficulty gaining admission to substance abuse treatment programs. Conclusion Chronic pain was a common co-occurring condition among individuals misusing opioids. Better efforts are needed to integrate pain management and substance abuse treatment for this population.

Continuing Care and Long-Term Substance Use Outcomes in Managed Care: Early Evidence for a Primary Care-Based Model

How best to provide ongoing services to patients with substance use disorders to sustain long-term recovery is a significant clinical and policy question that has not been adequately addressed. Analyzing nine years of prospective data for 991 adults who entered substance abuse treatment in a private, nonprofit managed care health plan, this study aimed to examine the components of a continuing care model (primary care, specialty substance abuse treatment, and psychiatric services) and their combined effect on outcomes over nine years after treatment entry. In a longitudinal observational study, follow-up measures included self-reported alcohol and drug use, Addiction Severity Index scores, and service utilization data extracted from the health plan databases. Remission, defined as abstinence or nonproblematic use, was the outcome measure. A mixed-effects logistic random intercept model controlling for time and other covariates found that yearly primary care, and specialty care based on need as measured at the prior time point, were positively associated with remission over time. Persons receiving continuing care (defined as having yearly primary care and specialty substance abuse treatment and psychiatric services when needed) had twice the odds of achieving remission at follow-ups (p<.001) as those without. Continuing care that included both primary care and specialty care management to support ongoing monitoring, self-care, and treatment as needed was important for long-term recovery of patients with substance use disorders.

Continuing Care and Long-Term Substance Use Outcomes in Managed Care: Early Evidence for a Primary Care-Based Model

Objectives: How best to provide ongoing services to patients with substance use disorders to sustain long-term recovery is a significant clinical and policy question that has not been adequately addressed. Analyzing nine years of prospective data for 991 adults who entered substance abuse treatment in a private, nonprofit managed care health plan, this study aimed to examine the components of a continuing care model (primary care, specialty substance abuse treatment, and psychiatric services) and their combined effect on outcomes over nine years after treatment entry. Methods: In a longitudinal observational study, follow-up measures included self-reported alcohol and drug use, Addiction Severity Index scores, and service utilization data extracted from the health plan databases. Remission, defined as abstinence or nonproblematic use, was the outcome measure. Results: A mixed-effects logistic random intercept model controlling for time and other covariates found that yearly primary care, and specialty care based on need as measured at the prior time point, were positively associated with remission over time. Persons receiving continuing care (defined as having yearly primary care and specialty substance abuse treatment and psychiatric services when needed) had twice the odds of achieving remission at follow-ups (p<.001) as those without. Conclusions: Continuing care that included both primary care and specialty care management to support ongoing monitoring, self-care, and treatment as needed was important for long-term recovery of patients with substance use disorders. (Psychiatric Services 62:1194–1200, 2011)

A pilot assessment of relapse prevention for heroin addicts in a Chinese rehabilitation center

Objectives: To conduct a pilot assessment of relapse prevention (RP) group therapy for heroin-dependent patients in a drug rehabilitation center in China. Methods: A randomized case–control study was conducted to assess the efficacy of RP delivered over a 2-month period to male heroin addicts (n = 50, RP group) in the Shanghai Labor Drug Rehabilitation Center (LDRC) compared with an equal number of participants (n = 50, labor rehabilitation (LR) group) in the LDRC program receiving standard-of-care treatment. Outcomes were assessed by the Beck Depression Inventory (BDI), the Self-Rating Anxiety Scale (SAS), the Self-Efficacy Scale (SE), and the Self-Esteem Scale (SES) after completion of RP, and by the Addiction Severity Index (ASI) and abstinence rates of heroin use at 3-month follow-up post release from the LDRC for both groups. Results: Significant improvements in scores on SAS, SE, and SES were found in the RP group after completion of the 2-month RP group therapy compared with the LR group (SAS 7.85 ± 6.20 vs 1.07 ± 5.42, SE 3.88 ± 3.60 vs .08 ± 2.89, and SES 3.83 ± 3.31 vs .78 ± 2.55). At 3-month follow-up, the RP group participants had more improvements on ASI scores in most domains and had higher abstinence rates than that in the LR group (37.2% vs 16.7%). Conclusions: An RP component can be effective in increasing abstinence rates among post-program heroin-dependent individuals and may help reduce anxiety and improve self-esteem and self-efficacy during and following treatment. Scientific Significance: This study suggests RP as a potentially effective component of treatment for heroin addicts.

Associations of Housing Status With Substance Abuse Treatment and Service Use Outcomes Among Veterans

Associations of Housing Status With Substance Abuse Treatment and Service Use Outcomes Among Veterans