Alcohol Screening Research Articles

Stakeholder-Informed Solutions To Address Barriers for Alcohol Screening and Brief Intervention in Thai Hypertension Care.

Premature deaths from NCDs disproportionately affect people in low- and middle-income countries. Since alcohol use is one of the most common causes of reversible hypertension, interventions targeting alcohol use may be a feasible and effective low-cost approach to synergistically reduce the prevalence of harmful drinking and high blood pressure. This study sought to identify key factors in successfully implementing alcohol use screening and brief intervention in hypertension care in Thailand. For this purpose, we surveyed participants (NRound 1 = 91, NRound 2 = 27) from three different groups of Thai stakeholders (policy- and decisionmakers, primary healthcare practitioners, and patients diagnosed with hypertension) in a two-round stakeholder elicitation. In round 1, we identified limited resources, lack of clear guidelines for lifestyle intervention, stigmatization, and inconsistent monitoring of patients' alcohol use as important barriers. In round 2, we sought to elicit solutions for the barriers identified in round 1. While stakeholders emphasized the need for adaptability to existing realities in Thai primary healthcare such as a high workload and limited digitization, they favorably evaluated a digital alcohol assessment tool with integrated, tailored advice for brief intervention as a potential scalable solution. Findings suggest that as one possible route to reduce the NCD burden caused by hypertension in Thailand, primary healthcare services may be enhanced by digital tools that support resource-effective, intuitive, and seamless delivery of alcohol screening and brief intervention.

Prevalence and Factors Associated with Self-Reported Substance Use among Patients with Mental Illness in Dar es Salaam, Tanzania: A Cross-Sectional Analytical Study

Background. Substance use is prevalent among patients with mental illness in low- and middle-income countries, including Tanzania. This heightened prevalence not only increases the risk of developing mental disorders and substance use disorders but also contributes to poor treatment outcomes for these patients. Despite these concerns, the current prevalence of substance use and its associated factors in this population remains unclear in Tanzania. Therefore, this study is aimed at determining the 12-month period prevalence of self-reported substance use and associated factors among patients with mental illness. Methods. We conducted a cross-sectional analytical study among patients with mental illness at Muhimbili National Hospital in Dar es Salaam, Tanzania. Respondents were selected using a systematic random sampling technique. Data on self-reported substance use were collected using the World Health Organization’s (WHO) alcohol, smoking, and substance involvement screening test (ASSIST) V3.0. IBM SPSS version 25 was employed for data analysis, utilizing frequencies and percentages to determine the prevalence of self-reported substance use. The study employed bivariate and multiple logistic regression analyses to investigate the association between patient characteristics and self-reported substance use, with statistical significance set at a p value of < 0.05. Results. A total of 364 patients were enrolled in the study, with 215 (59.1%) being male and a mean (SD) age of 35.57 (±9.01) years. Among the participants, 119 (32.7%) reported substance use. The most commonly used substances were alcohol (21.7%), tobacco (19.8%), and cannabis (12.9%). Factors significantly associated with self-reported substance use included younger age (AOR: 1.829; 95% CI: 1.112, 3.010; p=0.017), male gender (AOR: 2.346; 95% CI: 1.397, 3.939; p=0.001), positive family history of mental illness (AOR: 2.247; 95% CI: 1.364, 3.701; p=0.001), and a family history of substance use (AOR: 3.804; 95% CI: 2.305, 6.276; p<0.001). Conclusions. A significant proportion, amounting to one-third of patients, reported substance use, highlighting the imperative need for targeted measures within this population. The implementation of routine substance use screening programs for patients with mental illness is crucial, alongside gender-sensitive and age-specific interventions. Consideration of patients’ family history of mental illness and substance use should be an integral part of these measures.

Alcohol, Smoking and Substance Involvement Screening Test validity in bipolar and psychotic disorders.

Patients with multi-episode bipolar and psychotic disorders have a high prevalence of substance use disorders, with negative consequences. A brief, easily administered screening test such as the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) is needed to identify those at risk in order to intervene appropriately. However, the ASSIST has not yet been validated in this population. This article aims to determine the validity and reliability of the ASSIST in detecting substance use disorders in patients with multi-episode bipolar and psychotic disorders. Western Cape Province, South Africa. The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Health Disorders, 4th Edition (DSM-IV) Axis I Disorders (SCID-I) was used as the gold standard for detecting substance abuse and dependence. Cronbach's alpha was used to determine the internal consistency of the ASSIST, and receiver operating characteristic analysis was used to evaluate its screening properties. Optimal cut off scores were calculated to maximise sensitivity and specificity. A total substance involvement lifetime score of ≥13 was found to have optimal sensitivity and specificity of just over 74%. The optimal cutoff score for alcohol was ≥4 and for cannabis, methamphetamine, and 'other drugs' was ≥3. The area under the curve was 0.7 or above for both the total and specific substance involvement scores. The ASSIST is a psychometrically sound screening test for substance use disorders in patients with multi-episode bipolar and psychotic disorders. This is the first study to validate the ASSIST in this population.

DSM-5 conduct disorder and symptoms in youths at high risk of psychosis in Kenya with DSM-5 mental disorders and substance use: towards integrated management

Little is known about the prevalence of Conduct Disorder (CD) and symptoms of CD in high risk psychosis persons at both clinical and community populations in LMICs and in particular Kenya. This study aimed to document (1) the prevalence of CD diagnosis and symptoms in youth who screened positive for psychosis and (2) the associated mental disorders and substance use in the same cohort in LMIC. The sample size was 536 students who had screened positive on the Washington Early Recognition Center Affectivity and Psychosis (WERCAP) from a population of 9,742 high school, college and university students, but had not converted to a psychotic disorder. We collected data on socio-demographic characteristics and used the following tools: Economic indicators tool; the Diagnostic Interview Schedule (DIS) tool for DSM-5 diagnosis; World Health Organization (WHO) Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST). Basic descriptive statistics, chi-square test, Fisher's exact test, Pearson correlation and Poisson regression were conducted. Five percent (5%) of the respondents met the criteria for DSM-5 CD. Indeterminate CD comprised 10.1%. Male gender, all substances except hallucinogens lifetime, obsessive compulsive disorder, psychosis, agoraphobia, social phobia, drug abuse/dependence, antisocial personality disorder, oppositional defiant disorder, suicidality, WERCAP screen for bipolar disorder and WERCAP screen for schizophrenia were significantly (p < 0.05) associated with CD. Deceitfulness or theft criteria symptoms showed that CD had no significant gender difference. Criteria symptoms in aggression to people and animals, destruction of property and serious violations of rules were more common among males. Our findings suggest the need to screen for and diagnose CD, mental disorders and substance use in high risk psychosis youths in Kenya. This will inform integrated management.

Risk Factors for Opioid Misuse, Abuse, and Dependence Among Pain Clinic Patients: A Cross-Sectional Study at King Khalid University Hospital during 2020.

BACKGROUND Physicians are faced with the risk of patients developing opioid use disorders (OUDs) when prescribing patients opioids for long periods of time. Therefore, it is highly recommended to continuously monitor and evaluate long-term non-cancer pain patients who are prescribed opioids. This study aims to estimate the prevalence of OUDs in 103 patients with active opioid prescriptions attending the Pain Clinic at King Khalid University Hospital. MATERIAL AND METHODS A cross-sectional study was conducted at King Khalid University Hospital's pain clinic from 2020 to 2022. A list of all patients attending the Pain Clinic with an opioid prescription was provided by the hospital. Through telephone interviews, consent was secured followed by the collection of demographic variables and prescription-related variables. Additionally, patients were asked to complete the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST 3.1) opioid questionnaire. RESULTS Most of the 103 patients were at moderate risk for abuse (91.3%), while a smaller percentage were at high risk (dependence) (5.8%) and low risk (misuse) (2.9%). Tramadol was the most-prescribed opioid (43.7%). Young age (<50) (Z=2.534; P=0.011), opioid use for more than 90 days (Z=2.788; P=0.005), and the prescription of tramadol (Z=4.124; P<0.001) were associated with higher risk of OCDs. CONCLUSIONS Younger patients, opioid use >90 days, and tramadol are associated with a higher risk of opioid misuse. However, further studies on a larger scale and in various settings are needed to provide evidence accurately reflecting the general population, as this study focused on the population of pain clinic attendees.

INSOMNIA AND UNHEALTHY ALCOHOL USE DURING THE COVID-19 PANDEMIC AMONG WOMEN VETERANS AGE 50 YEARS AND OLDER

Abstract Older women Veterans have a high burden of comorbid medical and mental health conditions and may be particularly at risk for co-occurring insomnia and unhealthy alcohol use. Some research suggests rates of both increased during the COVID-19 pandemic; however, few studies extended beyond pandemic year one or examined administrative data. Using Department of Veterans Affairs (VA) electronic health record data, we examined rates of insomnia (diagnoses, prescription insomnia medications) and unhealthy alcohol use (diagnoses, positive alcohol screens) in a national sample of women Veterans aged 50 years and older (N=239,638) prior to and during the pandemic (March 2018-2022). During this timeframe, insomnia rates increased across age groups. Annual insomnia rates were highest among women ages 50-59 (12.8-14.9%) and lower for women age 60 and older (6.2-12.1%). The annual rate of unhealthy alcohol use was also highest among women ages 50-59 (13.9-15.3%) and lower for women age 60 and older (5.4-12.9%). For the youngest and oldest age groups, rates of unhealthy alcohol use decreased annually until 2021 and then increased; for women aged 60-79, rates increased except in 2020, when rates declined. The proportion of women with both conditions in a given year ranged from .5-2.9% and was highest at younger ages and lowest at older ages. Together, results indicate annual rates of insomnia and unhealthy alcohol use during COVID were highest in midlife women but increased over time across ages, signaling a potential need for intervention and prevention efforts aimed at addressing sleep health and alcohol use across mid-late adulthood.

Relationship Between Psychopathological Symptoms, Psychoactive Substances, And Antisocial Behaviour Among Undergraduate Students Of The University Of Lagos, Nigeria

Background Antisocial behaviour and its attendant effect are undesirable as it often negatively impacts individuals, communities, and overall social cohesion. Given that its threat to students' mental health and the smooth operation of post-secondary institutions is global, this unsettling trend has raised serious research concerns among interested stakeholders worldwide. Objective:The study assessed the relationship between psychopathological symptoms, substance abuse, alcohol use, and antisocial behaviour among undergraduate students. Method:The research utilised a cross-sectional survey method with one hundred (100) undergraduates purposively selected as participants. The Psychopathic Deviate scale, Symptom Distress Checklist (SCL-90), Drug Abuse Screening Test (DAST), and Alcohol Screening Questionnaire (AUDIT) were adopted to gather data for the study. Result:The findings showed that there is a significant positive correlation (r = 0.582, p&lt;.01) between substance abuse and antisocial behaviour; additionally, there is a significant positive correlation (r = 0.501, p&lt;.01) between alcohol abuse and antisocial behaviour. Psychopathology factors (somatization, obsessive, interpersonal, depression, anxiety, hostility, phobic anxiety, paranoid ideation, psychoticism, neuroticism, overall SDC) and antisocial behaviour also show a significant positive correlation at (r = 0.248, p&lt;.05; r = 0.238, p&lt;.05; r = 0.449, p&lt;.01; r = 0.404, p&lt;.01; r = 0.400, p&lt;.01; r = 0.461, p&lt;.01; r = 0.503, p&lt;.01; r = 0.314, p&lt;.01; r = 0.408, p&lt;.01; r = 0.314, p&lt;.01 &amp; r = 0.471, p&lt;.01) respectively. Conclusion:The study concluded that psychopathological symptoms and substance and alcohol abuse are positively associated with antisocial behaviour, thus likely to induce antisocial behaviour among undergraduates in Nigeria.

Nativity and the risk of opioid use disorder among Hispanic/Latinx women in primary care in Los Angeles, CA

Background: While rates of opioid use disorder (OUD) are lower among women compared to men, nativity may have disproportionate impacts on OUD risk among Hispanic/Latinx women but remain understudied. Objective: To assess the association between country of birth and reported OUD risk among low-income Hispanic/Latinx women in primary care in Los Angeles, CA. Methods: This was a cross-sectional study of 1189 non-pregnant, Hispanic/Latinx women attending two federally qualified health centers in Los Angeles between March and July 2013. OUD risk was assessed using the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST), and moderate-to-high risk was defined as ASSIST score ≥ 4. Results: Overall, 4.2% of women (n = 49) were at moderate-to-high risk for OUD. Risk for OUD was higher among US-born women compared to foreign-born women (6.7 vs. 1.7%; p < .01), those who reported 2+ chronic medical conditions (p < .01), and those who were at moderate-to-high risk for other substance use disorders (p < .01). In multivariable logistic regression analyses, being U.S.-born was independently associated with being at moderate-to-high risk for OUD among Hispanic/Latinx women as compared to those who were foreign-born (AOR = 2.8; 95% CI 1.2–6.8). Conclusion: Among low-income Hispanic/Latinx women presenting to primary care, one in twenty patients is at-risk for OUD. The odds of moderate-high risk of OUD were three times as high in US-born compared to foreign-born women, and higher among those with chronic medical conditions and those at risk of other substance use disorders. Gender-specific and culturally-tailored screening for OUD may inform overdose prevention interventions for US-born Hispanic/Latinx women.

Alcohol-related emergency department presentations and hospital admissions around the time of minimum unit pricing in Ireland

BackgroundMinimum unit pricing (MUP) was recently introduced in Ireland to reduce alcohol-related harms. The size of the impact of alcohol on hospital emergency departments (EDs) in Ireland is poorly understood due to inconsistent alcohol screening and documentation. AimsWe sought to systematically characterise the volume, timing, and nature of alcohol-related presentations and admissions to a busy urban ED in Dublin, Ireland. MethodPatients presenting to the ED were assessed by a dedicated clinician during selected time periods before (Nov–Dec 2021) and after (Feb–Apr 2022) the introduction of MUP. A total of 725 interviews were conducted over 168 h in the ED. FindingsAlcohol consumption was a factor in 19.4% of ED presentations and in 17.3% of hospital admissions across the entire study period. A reduction in overall alcohol-related ED presentations was noted in the period following MUP, although it is not possible to conclude a direct effect. ConclusionAlcohol-related harm places a significant strain on EDs and hospitals, and the impact of MUP on hospital burden in Ireland merits further evaluation. Effective measures at local and population levels are urgently required to address this burden.

The relationship between discrimination, alcohol use severity, and PTSD symptoms among Latinx heavy drinkers

IntroductionDiscrimination is linked to alcohol use severity among Latinx adults, who also show high prevalence rates of PTSD compared to non-Latinx adults. We know little about whether PTSD symptoms affects the relationship between discrimination and alcohol use severity. We hypothesized that the association between discrimination and alcohol use severity might differ by level of PTSD symptom severity. MethodsThis is a secondary cross-sectional analysis of data collected at baseline from a completed randomized clinical trial testing the relative efficacy of a culturally adapted motivational interview designed to address discrimination and drinking behavior against an unadapted motivational interview for Latinx adults. Eligible participants screened positive for the NIAAA Single Alcohol Screening Question for heavy drinking days, identified as Latinx, and were 18–65 years old. We assessed the Everyday Discrimination Scale, Primary Care PC-PTSD screener, Alcohol Use Disorder Identification Test, and the Short Acculturation Scale for Hispanics. The study analyzed the main and interactive effects of discrimination and PTSD symptoms on alcohol use severity, while controlling for age, sex, household income, and acculturation. ResultsAfter controlling for covariates in model 2, the interaction of discrimination and PTSD symptoms was significantly related to alcohol use severity. Simple slopes analysis indicated that discrimination was positively related to alcohol use severity among those with high (1 SD above the mean) but not low (1 SD below the mean) levels of PTSD symptoms. ConclusionsEvidence suggests that the experiences of discrimination were associated with alcohol use severity among those who reported more PTSD symptoms. Specifically, discrimination may have a stronger effect on alcohol use severity among Latinx adults who report more PTSD symptoms. Screening Latinx adults for heavy drinking days, discrimination, and PTSD symptoms is clinically important. Culturally adapted alcohol interventions that target discrimination may be particularly effective for Latinx individuals with more PTSD symptoms.

Participation in Australian drug treatment programs for individuals engaging in high-risk substance use: Data from a nationally representative sample.

Substance use, including drugs, alcohol and smoking have a significant health, social and economic impact. We aim to assess the rate and factors associated with treatment access among individuals with high-risk substance use. This study is a cross-sectional analysis of the 2019 Australian National Drug Strategy Household Survey (N = 22,015). Participants were persons with high-risk substance use based on the Alcohol, Smoking and Substance Involvement Screening Test-Lite (ASSIST-Lite) and current smokers. We measured self-reports of past 12-month engagement in a tobacco, alcohol or other drugs treatment program. Overall, 0.4% had high-risk drug use (0.3% cannabis, 0.1% meth/amphetamine or 0.1% opioids), 7.4% had high-risk alcohol use, and 14.0% currently smoked. Among high-risk users, past 12-month treatment access rates were 50.6% [22.3-78.9%] for opioids, 27.1% [8.1-46.1%] for meth/amphetamine, 14.5% [4.3-24.7%] for cannabis, 9.6% [8.1-11.0%] for alcohol and 11.7% [10.6-12.9%] for current smoking. The primary source of treatment support was information and education (12.7% drugs, 4.6% alcohol, 4.0% smoking), followed by counselling (6.7% drugs, 4.5% alcohol, 3.0% smoking). Online or internet support was accessed by 5.9% (drug) and 1.6% (alcohol) people with high-risk use. Psychological distress was associated with treatment access (drugs: odds ratio 3.03 [0.77-11.95], p = 0.111; alcohol: odds ratio 3.16 [2.20-4.56], p ≤ 0.001; smoking: odds ratio 1.95 [1.52-2.49], p ≤ 0.001). The proportion of people engaging in risky substance use who had used treatment programs remains low, especially for alcohol. Public health strategies to scale up treatment access are warranted.

The Relationship between Vaping Cannabis and Frequency of Cannabis Use and Cannabis-Related Problems among Urban High School Students

Background: Vaping, including vaping cannabis, is increasing among adolescents. In this longitudinal study, we examined the relationship between vaping cannabis and frequency of cannabis use and related problems over 6 months among adolescents. Material and Methods: Data were from 233 participants (46.8% male, 93.1% African American, mean age = 16.4 years) reporting cannabis use. The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) assessed frequency of past 30-day cannabis use and cannabis-related problems at baseline, 3- and 6-months post-baseline. We used latent growth curve modeling to compare vaping to non-vaping adolescents on trends in cannabis use frequency and ASSIST cannabis scores. Results: Adolescents who vaped cannabis (11.7%) had higher past 30-day frequency (mean = 17.89 days, SD = 10.49) of cannabis use at baseline compared to adolescents who had not vaped (mean = 12.1 days, SD = 10.93), but reported a significantly sharper decline in frequency of cannabis use (b = −0.34, p = 0.017). A significantly steeper decrease existed in the mean cannabis ASSIST scores for the vaping group than for the non-vaping group (b = −0.34, p = 0.014). Mean ASSIST scores on the cannabis subscale between the two groups were significantly different at 6-month follow-up (Vape mean = 6.00, SD = 8.12 vs. Non-vape mean = 9.6, SD = 9.39; p < 0.021). Conclusions: In a sample of cannabis-using adolescents, adolescents with experience vaping cannabis, compared to adolescents without vaping experience, on average reported sharper decreases in frequency of cannabis use and cannabis-related problems such as health or social problems.

Exploratory analysis of the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST): correlations and rankings among U.S. college students

ABSTRACT Objective We conducted an exploratory analysis of The Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) psychometric tool using the specific substance involvement score (SSIS) measures among U.S. college students to evaluate the relationships among 11 substance screening tools (prescription opioids, heroin, tobacco, alcohol, cannabis, cocaine, methamphetamine, prescription stimulants, inhalants, sedatives, and hallucinogens). Methods We used data from the American College Health Association’s National College Health Assessment (fall 2019–spring 2021). Correlations and network analyses were conducted. Results We identified significantly positive correlations for all substance screening tools, with the strongest correlations seen between screening tools for heroin and prescription opioids. Cannabis ranked highest in screening for alcohol risk, alcohol highest in screening for tobacco and cannabis risk, prescription opioids highest in screening for heroin and cocaine, and inhalants highest in screening for other illicit drugs. Conclusions This study is the first to explore the application of the ASSIST tool in U.S. college students. The rankings represent a unique exploratory analysis evaluating the relationship between substance screening tools and substance use behavior in this population. As such, our findings provide a valuable foundation for future research.

Implementation of mandatory blood alcohol screening in trauma patients: A retrospective study from a tertiary trauma center in a Middle Eastern country

BackgroundAlcohol consumption is a significant risk factor for several types of injuries and trauma recidivism and remains an important public health concern worldwide. We aimed to describe the implementation of mandatory alcohol screening and the AUDIT tool among trauma patients admitted to a level 1 trauma center in a country with a partial ban on alcohol consumption. MethodsThis was a retrospective analysis of trauma patients (>12 years old) who required hospital admission and underwent blood alcohol concentration (BAC) screening between 2014 and 2019. This was achieved via an enzymatic method using alcohol dehydrogenase for ethanol detection in the plasma and serum samples. Trauma patients with a BAC <2.2 mmol/L were referred to as “negative”, and BAC >2.2 mmol/L was referred to as “BAC positive”. A comparative analysis was performed between the two BAC groups. Alcohol Screening, Brief Intervention, Referral for Treatment [ASBIRT] program, and AUDIT were applied. ResultsA total of 7326 BAC screening tests were performed on 7284 patients during the study period. With slight variation over the years, the compliance rate was 77% (70.4%–85.3%), and the test positivity rate was 10% (8.6%–12.5%). There were 42 repeated admissions, of which seven patients were BAC positive at every admission. Young age and non-Arab patients were more likely to test positive, and the main mechanism of injury (MOI) was road traffic-related trauma (p < 0.05). Assault and self-inflicted injuries were significantly higher in BAC-positive patients than in BAC-negative patients (18% vs. 4% and 2.7% vs. 1.3%, respectively; p = 0.001). The injury severity score (ISS) and mortality rate were comparable between the study groups. Patients with a positive BAC were significantly more likely to undergo pan-CT scan in the emergency department, intubation, and exploratory laparotomy than those with a negative BAC. In patients who sustained injuries due to assault, all-terrain vehicles, or motorcycle crashes, there was a significant association between the positivity of BAC tests and the patient's ISS. ConclusionDespite improvements in BAC screening in trauma admissions over the years, almost 20% of cases were missed. Although the mortality rates were comparable, alcohol consumption burdens resources in terms of excess imaging, intubation, open abdominal surgery, and possible disability. Further studies are needed to understand the key obstacles and challenges to achieving optimum compliance for screening in trauma settings.

Abstract A002: Alcohol use patterns and patient-provider discussions about alcohol use among cancer survivors: Differences by race and ethnicity in the National Survey of Drug Use and Health

Abstract Background: Alcohol is a leading modifiable risk factor for cancer risk and recurrence. The American Cancer Society recommends abstaining from alcohol for cancer prevention and advises that those who choose to drink should limit their intake. Healthcare providers are uniquely positioned to counsel cancer survivors about alcohol’s harms. Prior research has revealed stark differences in heavy drinking among cancer survivors by race and ethnicity. We build on this work by examining the prevalence of multiple alcohol use patterns, alcohol screening, and patient-provider discussions about alcohol by race and ethnicity among a cancer survivor population. Methods: We conducted a cross-sectional study using data from the National Survey on Drug Use and Health (NSDUH) 2015-2019. Eligible respondents included adults (18+ years) who reported a prior cancer diagnosis. Outcomes included alcohol use patterns (lifetime abstention, alcohol use and binge drinking in the past 30 days), alcohol screening in the past year, and report of an in-person alcohol discussion with a healthcare provider in the past year. We estimated the adjusted prevalence of these outcomes by race and ethnicity from marginal effects of logistic regression models that accounted for sociodemographic characteristics (i.e., age, gender, educational attainment, household income) and health insurance type. Models included cluster, strata, and weight variables to account for the complex survey design and nonresponse bias. Results: The unweighted analytic sample size included 6,240 cancer survivors – 431 identified as Black, Non-Hispanic; 461 identified as Hispanic, and 5,348 identified as White, Non-Hispanic. Though not statistically significant, adjusted binge drinking prevalence was highest among Black, Non-Hispanic survivors (17.3% [95% CI: 11.6 – 23.0]) followed by White survivors (13.4% [95% CI: 12.2 – 14.6]) and Hispanic survivors (13.1% [95% CI: 9.8 – 16.4]). Significant differences in adjusted binge drinking prevalence by race and ethnicity were found for binge drinking among current drinkers – Black (41.4% [95% CI: 30.7 – 52.1]), Hispanic (31.7% [95% CI: 22.6 – 40.8]), White (26.7% [95% CI: 24.6 – 28.8]). No significant differences were found for alcohol screening prevalence by race and ethnicity. Black (44.7% [955 CI: 36.4 – 53.0]) and Hispanic (48.8% [95% CI: 40.1 – 57.6%]) cancer survivors were less likely than White survivors (56.9% [95% CI: 54.9 – 59.0]) to report an in-person provider discussion about alcohol. Conclusions: There is a significant racial disparity in problematic drinking between Black, Hispanic, and White cancer survivors, with higher proportions of Black and Hispanic survivors reporting binge drinking than their White peers. Yet, Black and Hispanic cancer survivors are less likely to have an in-person discussion with a provider about alcohol use compared with White cancer survivors. Black and Hispanic cancer survivors may not be receiving important messages about alcohol’s harms from their providers, who could be important sources of this information. Citation Format: Naomi K. Greene, David Dean Jr. Alcohol use patterns and patient-provider discussions about alcohol use among cancer survivors: Differences by race and ethnicity in the National Survey of Drug Use and Health [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A002.

Childhood and adolescent factors shaping vulnerability to underage entry into sex work: a quantitative hierarchical analysis of female sex workers in Nairobi, Kenya

ObjectiveTo explore factors associated with early age at entry into sex work, among a cohort of female sex workers (FSWs) in Nairobi, Kenya.BackgroundYounger age at sex work initiation increases the...

Evaluating the agreement between different substance use recall periods in multiple HIV cohorts

BackgroundThis study aims to evaluate the agreement in substance use on both binary and ordinal scales between 3-month and 6-month recall periods with samples from different communities, demographic backgrounds, and HIV status. MethodsWe administered the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) to 799 participants from three different North American cohorts focused on substance use and HIV. We conducted a within-person agreement analysis by calculating the agreement levels and Kappa statistic between data collected using the 3-month recall ASSIST and 6-month custom substance use surveys as well as different terminology for each substance in multiple cohorts. ResultsFor all drugs studied, the agreement on the binary use or ordinal frequency of use metrics showed a high agreement level between 80.4% and 97.9% and an adequate adjusted kappa value between 0.61 and 0.96, suggesting substantial agreement. According to the agreement criteria we proposed, substance use data collected using different recall periods and with variation in drug names can be harmonized across cohorts. ConclusionsThis study is the first to evaluate the feasibility of data harmonization of substance use by demonstrating high level of agreement between different recall periods in different cohorts. The results can inform data harmonization efforts in consortia where data are collected from cohorts using different questions and recall periods.

Drug Dependency Due to Traumatic Childhood Experiences and Low Emotional Intelligence of Juvenile Felons in India

ABSTRACT Children involved with the juvenile justice system for engaging in unlawful acts are more likely than their peers of the same age to use cannabis and alcohol, which increases the likelihood of adverse behavioral outcomes and prolonged involvement with the judicial system. This study focuses on the relationship between child maltreatment, emotional intelligence and drug dependence among children in conflict with the law. The participants of the study are 130 justice-involved male juveniles in the Indian state of Tamil Nadu who are given the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST), the Juvenile Victimization Questionnaire (JVQ), and Emotional Intelligence Scale (EIS) for assessment. Interviews are conducted to obtain the data required for the study. For the statistical analysis, frequency, t-test, correlation, and regression analyses are used. Results of the study indicates that low level/lack of emotional intelligence which enhances the likelihood of juveniles being in conflict with the law and engaging in harmful, drug-dependent behavior. No significant relationship is observed between child maltreatment and drug-dependent behavior. For these juveniles, marijuana serves as the gateway drug. Peer influence and school dropout have a substantial influence on drug-dependent behavior.

Clinical evaluation of the alcohol use disorders identification test (AUDIT) in Moshi, Tanzania.

Alcohol use disorder is a major cause of morbidity and mortality in low- and middle-income countries. Alcohol screening using a validated tool is a useful way to capture high-risk patients and engage them in early harm reduction interventions. Our objectives were to 1) evaluate the psychometric evidence the Alcohol Use Disorders Identification Test (AUDIT) and its subscales in the general population of Moshi, Tanzania, and 2) evaluate the usefulness of the tool at predicting alcohol-related harms. Two hundred and fifty-nine adults living in Moshi, Tanzania were included in the study. We used the AUDIT and its subscales to determine the classification of harmful and hazardous drinking. To analyze the internal structure of AUDIT and the model adequacy we used Confirmatory Factor Analysis (CFA). The reliability of AUDIT was analyzed for Cronbach's alpha, Omega 6 and Composite Reliability. The optimal cut off point for the AUDIT was determined by the receiver operating characteristic (ROC) curve, using the Youden approach to maximize sensitivity and specificity. The median score of the AUDIT was 1 (inter-quartile range: 0-7). The internal structure of the AUDIT showed factor loadings ranging from 0.420 to 0.873. Cronbach's alpha, Omega and Composite Reliability produced values above 0.70. The Average Variance Extracted was 0.530. For the AUDIT, a score of 8 was identified as the ideal cut-off value in our population. This study validates AUDIT in the general population of Moshi and is one of the only studies in Africa to include measures of the internal structure of the AUDIT and its subscales.

The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST-Lite): translation and reliability of the Malay version

ABSTRACT Background Early screening and interventions are necessary to curb the negative consequences of youth substance use. ASSIST-Lite is the short form of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST 3.0) for rapid screening of substance-use disorder. This study aims to translate and validate the ASSIST-Lite questionnaire into the Malay language. Methods The ASSIST-Lite instrument, consisting of 6 main components with 3–4 items and two extra items was translated via the forward-backward process. Face and content validity was assessed by expert panels from relevant fields. Internal reliability was measured using Kuder-Richardson 20, and test-retest reliability was measured using Cohen’s Kappa. Results The item level of content validity index (I-CVI) is 1.00 for all items. There were 511 respondents, and a majority were Malays. The age range was 13 to 49 years old, with a mean age of 17 (SD = 6.392). Both internal and test-retest reliability showed satisfactory results with alpha value between 0.772 to 0.882 and Kappa value between 0.8 to 1, respectively. Conclusions The Malay version of ASSIST-Lite is reliable to screen substance use and its severity risk. However, further studies are required to evaluate its sensitivity and effectiveness in the clinical setting.