Alcohol Smoking And Substance Involvement Screening Test Research Articles

Using the Alcohol, Smoking and Substance Involvement Screening Test to predict substance-related hospitalisation after release from prison: A cohort study.

Poor substance use-related health outcomes after release from prison are common. Identifying people at greatest risk of substance use and related harms post-release would help to target support at those most in need. The Alcohol Smoking and Substance Involvement Screening Test (ASSIST) is a validated substance use screener, but its utility in predicting substance-related hospitalisation post-release is unestablished. We measured whether screening for moderate/high-risk substance use on the ASSIST was associated with increased risk of substance-related hospitalisation. A prospective cohort study. Prisons in Queensland and Western Australia. Participants were incarcerated and within 6weeks of expected release when recruited. A total of 2585 participants were followed up for a median of 873 days. Baseline survey data were combined with linked unit record administrative hospital data. We used the ASSIST to assess participants for moderate/high-risk cannabis, methamphetamine and heroin use in the 3months prior to incarceration. We used International Classification of Diseases (ICD) codes to identify substance-related hospitalisations during follow-up. We compared rates of substance-related hospitalisation between those classified as low/no-risk and moderate/high-risk on the ASSIST for each substance. We estimated adjusted hazard ratios (aHR) by ASSIST risk group for each substance using Weibull regression survival analysis allowing for multiple failures. During follow-up, 158 (6%) participants had cannabis-related, 178 (7%) had opioid-related and 266 (10%) had methamphetamine-related hospitalisation. The hazard rates of substance-related hospitalisation after prison were significantly higher among those who screened moderate/high-risk compared with those screening low risk on the ASSIST for cannabis (aHR 2.38, 95% confidence interval [CI] 1.74, 3.24), methamphetamine (aHR 2.23, 95%CI 1.75, 2.84) and heroin (aHR 5.79, 95%CI 4.41, 7.60). Incarcerated people with an Alcohol Smoking and Substance Involvement Screening Test (ASSIST) screening of moderate/high-risk substance use appear to have a significantly higher risk of post-release substance-related hospitalisation than those with low risk. Administering the ASSIST during incarceration may inform who has the greatest need for substance use treatment and harm reduction services in prison and after release from prison.

Evaluating psychometric properties of the Thai-version Alcohol Smoking and Substance Involvement Screening Test (ASSIST)

ABSTRACT Background Alcohol use disorders and illicit drug use disorder are important causes of mortality and disability in adolescents. This study evaluated psychometric properties of the Thai-version Alcohol Smoking and Substance Involvement Screening Test (ASSIST). Two subscales were tested, including the Tobacco and Alcohol. Method 624 participants from three high schools in Bangkok and Nakornpathom province, Thailand were recruited. Research instruments included self-reported questionnaire of demographic data and the ASSIST Thai-version. The construct validity and concurrent of the scale was test using structural equation modeling with AMOS 23.0. Internal consistency reliability was tested by using reliability analyses. Results Results showed that the ASSIST Thai-version displayed one-factor solution for both assessment of Tobacco and Alcohol. Factor loadings for Tobacco ranged from .40 to .96 and for Alcohol those were in the range of .28 - .82. Construct and concurrent validity of the instrument were supported by the results from this study. Cronbach’s alpha was .82 for Tobacco and .73 for Alcohol, indicating good and acceptably reliability. Conclusion The results showed adequate psychometric properties of the Thai version ASSIST. Thus, this scale is appropriate to use for screening specifically in Tobacco and Alcohol use among Thai adolescents.

Alcohol and drug use in a sample of Brazilian Army soldiers

Objective: To identify the pattern of use of alcohol and other drugs and its related sociodemographic variables in a sample of Brazilian Army soldiers. Materials and method: Cross-sectional study conducted with 229 soldiers from an infantry battalion at the Brazilian Army. Data were collected in 2019 with the application of a sociodemographic and employment instrument, the Alcohol Smoking and Substance Involvement Screening Test (ASSIST), and the Pearson correlation test. Results: The prevalence of alcohol use was present in more than half of the studied sample, followed by tobacco and cannabis sativa. Regarding the pattern of use, alcohol (22.2%), tobacco (31%), and cannabis sativa (9.7%) reported significant results. The sociodemographic variables of the individuals in the sample, their educational level (years of schooling), and economic-related issues were the main variables associated to alcohol and drug use. Conclusions: The consumption of alcohol and other drugs by the military is lower than that identified for the general population in the Brazilian territory. The use of psychoactive substances in the military context is often part of an attempt to deal with stress. Therefore, it is necessary to implement strategies aimed at preventing alcohol and drug use and promoting mental health among this population.

Implementing a Substance-Use Screening and Intervention Program for People Living with Rifampicin-Resistant Tuberculosis: Pragmatic Experience from Khayelitsha, South Africa.

Substance use (SU) is associated with poor rifampicin-resistant tuberculosis (RR-TB) treatment outcomes. In 2017, a SBIRT (SU screening-brief intervention-referral to treatment) was integrated into routine RR-TB care in Khayelitsha, South Africa. This was a retrospective study of persons with RR-TB who were screened for SU between 1 July 2018 and 30 September 2020 using the ASSIST (Alcohol, Smoking and Substance Involvement Screening Test). Here we describe outcomes from this program. Persons scoring moderate/high risk received a brief intervention and referral to treatment. Overall, 333 persons were initiated on RR-TB treatment; 38% (n = 128) were screened for SU. Of those, 88% (n = 113/128) reported SU; 65% (n = 83/128) had moderate/high risk SU. Eighty percent (n = 103/128) reported alcohol use, of whom 52% (n = 54/103) reported moderate/high risk alcohol use. Seventy-seven persons were screened for SU within ≤2 months of RR-TB treatment initiation, of whom 69%, 12%, and 12% had outcomes of treatment success, loss to follow-up and death, respectively. Outcomes did not differ between persons with no/low risk and moderate/high risk SU or based on the receipt of naltrexone (p > 0.05). SU was common among persons with RR-TB; there is a need for interventions to address this co-morbidity as part of “person-centered care”. Integrated, holistic care is needed at the community level to address unique challenges of persons with RR-TB and SU.

Drug Abuse Prevalence Among 10th - 12th-Grade Students of Kerman, Iran in 2017 - 2018 Academic Year

Background: It is generally accepted that due to various reasons, the age of drug abuse prevalence continues to decline, which imposes numerous personal and social dysfunctions. Objectives: This study aimed to assess the prevalence of drug abuse among adolescents in Kerman, Iran. Methods: This cross-sectional study was conducted on 2,000 10th - 12th-grade students in the academic year of 2017 - 2018 selected by random cluster sampling. Data collection tools included demographic characteristics checklist and alcohol smoking and substance involvement screening test (ASSIST). Data were analyzed using chi-square test. Results: The results showed that the highest prevalence of substance abuse among students was related to tobacco, alcohol, and sedatives. It was also demonstrated that the use of cigarettes, sedatives, cannabis, and amphetamine was significantly higher among male subjects compared to female participants (P < 0.05). Moreover, 16.4, 12.9, and 5.1% of the tobacco, alcohol, and sedative users required low interventions, respectively, whereas 1.5, 0.8, and 0.4% of them required high interventions, respectively. Conclusion: According to the results of the study, there was higher drug abuse prevalence in male students compared to female students. As such, it seems that consumption of alcohol, tobacco, and narcotics in adolescents requires serious intervention.

Validation of simple dichotomous self-report on prenatal alcohol and other drug use in women attending midwife obstetric units in the Cape Metropole, South Africa

Background This paper examines the degree of agreement among simple dichotomous self-report, validated screening results, and biochemical screening results of prenatal alcohol and other drug use among pregnant women. Method Secondary analysis was conducted on a cohort of pregnant women 16 years or older, presenting for prenatal care in the greater Cape Town, South Africa. Dichotomous verbal screening is a standard of care, and pregnant patients reporting alcohol and other drug use in dichotomous verbal screenings were asked to engage in screening using the Alcohol Smoking and Substance Involvement Screening Test (ASSIST) and urinalysis. Results Significant agreements between dichotomous and ASSIST scores were observed (K = 0.73–0.76). A higher rate of self-reported (36.9%) alcohol use was detected, relative to urine screening (19.6%) with a predictive value of 34.9; while underreporting of illicit substance use was observed (3.6% self-report vs. 8.8% urine screening) with an overall predictive value of 50.0. Conclusion Dichotomous verbal screening was considered valid after comparison with the ASSIST; however, combined use with urine screenings can be recommended especially for identifying illicit substance use in order to accurately detect alcohol and other drug use in pregnancy, so that women can be identified and referred for appropriate interventions where needed.

Screening and brief intervention for lower-risk drug use in primary care: A pilot randomized trial

AimsThe efficacy of screening and brief intervention for lower-risk drug use is unknown. This pilot study tested the efficacy of two brief interventions (BIs) for drug use compared to no BI in primary care patients with lower-risk drug use identified by screening. MethodsWe randomly assigned participants identified by screening with Alcohol Smoking and Substance Involvement Screening Test (ASSIST) drug specific scores of 2 or 3 to: no BI, a brief negotiated interview (BNI), or an adaptation of motivational interviewing (MOTIV). Primary outcome was number of days use of main drug in the past 30 as determined by validated calendar method at 6 months. Analyses were performed using negative binomial regression adjusted for baseline use and main drug. ResultsOf 142 eligible adults, 61(43 %) consented and were randomized. Participant characteristics were: mean age 41; 54 % male; 77 % black. Main drug was cannabis 70 %, cocaine 15 %, prescription opioid 10 %; 7% reported injection drug use and mean days use of main drug (of 30) was 3.4. At 6 months, 93 % completed follow-up and adjusted mean days use of main drug were 6.4 (no BI) vs 2.1 (BNI) (incidence rate ratio, IRR 0.33[0.15−0.74]) and 2.3 (MOTIV) (IRR 0.36[0.15−0.85]). ConclusionsBI appears to have efficacy for preventing an increase in drug use in primary care patients with lower-risk use identified by screening. These findings raise the potential that less severe patterns of drug use in primary care may be uniquely amenable to brief intervention and warrant replication.

Drug Use Among Adolescents and Young Adults with Unsuppressed HIV Who Use Alcohol: Identifying Patterns of Comorbid Drug Use and Associations with Mental Health.

Youth living with HIV (YLWH; aged 16-24) are at elevated risk of alcohol and drug use. Studies in older populations have identified patterns or profiles of multiple substance use differentially associated with mental health and anti-retroviral therapy (ART) adherence. No studies of YLWH have yet examined such patterns. A sample of 179 YLWH, reporting ART non-adherence and alcohol use, were recruited at five Adolescent Trials Network clinics in urban areas of the US between November 2014 and August 2017. Participants completed the Alcohol Smoking and Substance Involvement Screening Test (ASSIST) to assess substance use involvement scores, and the Brief Symptom Inventory. Latent Profile Analysis identified three substance use patterns: minimal illicit drug use (15.1%), cannabis only (56.4%), and global polysubstance use (28.5%). Global polysubstance users experienced more mental health problems compared to the minimal illicit drug usegroup. The co-occurrence of drug use with alcohol was common among these YLWH-all of whom reported ART adherence problems-indicating the importance of interventions capable of addressing multiple substance use rather than alcohol alone.

Alcohol Use Disorders and Associated Factors among an Elderly Community Sample in Nigeria: A Cross-Sectional Survey

Background: Alcohol Use Disorders (AUDs) in the elderly are associated with impairments in physical, psychological, social and cognitive functioning. Both the elderly men and women who drink alcohol are at a greater risk of social isolation and economic deprivation and the women in particular are in the danger of rapid development of dependence a phenomenon termed “telescoping” dependence. This study seeks to determine the prevalence of alcohol use disorders as well as their associated factors among the elderly in Jos South LGA, Plateau State, Nigeria. Methods: A community-based cross-sectional study of elderly (≥60 years) men and women. A total of 400 out of a total of 422 elderly community dwellers identified were interviewed with the aid of a composite questionnaire incorporating the socio-demography, Alcohol Smoking and Substance Involvement Screening Test (ASSIST), Mini International Neuropsychiatric Interview (MINI) and the 12-item General Health Questionnaire (GHQ-12). Results: The lifetime and current prevalence of alcohol use were 69.8% and 45.5% respectively. The prevalence of AUDs was (n = 52, 13.0%). AUDs was significantly associated with being male (OR = 2.57, 95%CI: 1.35 - 3.77, p χ2 = 0.34, 0.56), cardiovascular (χ2 = 0.42, p = 0.52), respiratory (χ2 = 0.55, p = 0.46), and digestive (χ2 = 0.17, p = 0.68) problems, though not statistically significant. Similarly, no significant associations were seen with probable psychiatric co-morbidity (χ2 = 2.35, p = 0.13) and chronic pain (χ2 = 0.52, p = 0.47). Conclusions: Alcohol use and use disorders were common in this elderly cohort. AUDs were associated with poorer health indices.

Factors Associated with Tobacco Use among Community Dwelling Older Adults in Jos South, Nigeria

Background: Tobacco use poses an enormous threat to public health worldwide. Its use is associated with an epidemic of cancer, heart disease, stroke, chronic lung disease and other non-communicable diseases especially with increases in age leading to increase morbidity and mortality. The aim of the study was to determine prevalence and associated factors with tobacco use among elderly members of a community in Jos South LGA, Plateau State, Nigeria. Methods: Data was collected from 17th to 31st August, 2018. The study employed a cross sectional design. Out of 422 elderly members (≥60 years) of the community identified, only 400 were interviewed with a composite questionnaire that includes the following: socio-demography, Alcohol Smoking and Substance Involvement Screening Test (ASSIST), Mini International Neuropsychiatric Interview (MINI) as well as the 12-item General Health Questionnaire (GHQ-12). Results: Results show the lifetime prevalence of tobacco use to be 17.5% and current prevalence to be 15.8%. Tobacco use disorders were not significantly associated with gender (X2 = 0.10, p2 = 0.03, p = 0.96), respiratory (X2 = 0.21, p = 0.65), digestive (X2 = 3.86, p = 0.05), difficulty ambulating (X2 = 0.34, 0.56), probable psychiatric co-morbidity (X2 = 0.12, p = 0.72) and chronic pain conditions (X2 = 0.74, p = 0.39), and had more hospital visits (X2 = 1.18, p = 0.40), and admissions (X2 = 0.03, p = 0.96) but the relationships did not attain statistical significance. Conclusion: We conclude that tobacco use is highly prevalent among older adults living in the community. There is need to step up efforts on programs of intervention especially smoking cessation programs and as a result reduce the burden of tobacco related diseases and disorders.

Associations Among Psychological Distress, Adverse Childhood Experiences, Social Support, and Resilience in Incarcerate Men

This study examines the association between psychological distress and two aggravating factors (childhood adversity and substance use) and two mitigating factors (social support and resilience) in a correctional sample of 943 men. Participants completed a questionnaire probing psychiatric distress using the DASS (Depression, Anxiety, and Stress Scale) and substance use behaviors using the ASSIST (Alcohol, Smoking, and Substance Involvement Screening Test). Adverse childhood experiences (ACEs) were measured incrementally and cumulatively. ACEs were reported by a majority (57.6%) of the sample. The number of ACEs and childhood emotional, physical, and sexual abuse experiences were strongly and consistently associated with prison-based psychological distress. The graded relationship found between ACE and psychological distress among incarcerated men supports the cumulative risk hypothesis. Prison-based substance use was positively associated with psychological distress, whereas resilience and, to a lesser extent, social support were negatively associated with distress. These findings can be used to inform the design of trauma-sensitive integrated interventions in correctional settings for men.

Web-Based Alcohol, Smoking, and Substance Involvement Screening Test Results for the General Spanish Population: Cross-Sectional Study.

BackgroundInformation technology in health sciences could be a screening tool of great potential and has been shown to be effective in identifying single-drug users at risk. Although there are many published tests for single-drug screening, there is a gap for concomitant drug use screening in general population. The ASSIST (Alcohol, Smoking and Substance Involvement Screening Test) website was launched on February 2015 in Madrid, Spain, as a tool to identify those at risk.ObjectiveThe aim of this study was to describe the use of a tool and to analyze profiles of drug users, their consumption patterns, and associated factors.MethodsGovernment- and press-released launching of a Spanish-validated ASSIST test from the World Health Organization (WHO) was used for voluntary Web-based screening of people with drug-related problems. The tests completed in the first 6 months were analyzed .ResultsA total of 1657 visitors of the 15,867 visits (1657/15,867, 10.44%) completed the whole Web-based screening over a 6-month period. The users had an average age of 37.4 years, and 78.87% (1307/1657) screened positive for at least one of the 9 drugs tested. The drugs with higher prevalence were tobacco (840/1657, 50.69%), alcohol (437/1657, 26.37%), cannabis (361/1657, 21.79%), and sedatives or hypnotics (192/1657, 11.59%). Polyconsumption or concomitant drug use was stated by 31.80% (527/1657) of the users. Male respondents had a higher risk of having alcohol problems (odds ratio, OR 1.55, 95% CI 1.18-2.04; P=.002) and double the risk for cannabis problems (OR 2.07, 95% CI 1.46-2.92; P<.001). Growing age increased by 3 times the risk of developing alcohol problems for people aged between 45 and 65 years (OR 3.01, 95% CI 1.89-4.79; P<.001).ConclusionsA Web-based screening test could be useful to detect people at risk. The drug-related problem rates detected by the study are consistent with the current literature. This tool could be useful for users, who use information technology on a daily basis, not seeking medical attention.

Country-wide distance training for delivery of screening and brief intervention for problematic substance use: A pilot evaluation of participant experiences and patient outcomes

ABSTRACTBackground: In this study, the authors evaluated if the 120-hour distance learning (DL) course SUPERA (an acronym in Portuguese meaning “System for detection of excessive use or dependence on psychoactive substances: brief Intervention, social reinsertion and follow-up”) was an effective way to train health professionals and social workers to apply screening and brief intervention (SBI) for patients with substance use disorders. Methods: In the first phase, 2420 health professionals or social workers, who had completed the course, answered an online survey about their use of the SBI. In the second phase, 25 of those professionals applied the ASSIST (Alcohol, Smoking and Substance Involvement Screening Test) followed by a brief intervention (BI) to patients with substance use disorders. Three months after the SBI delivery, independent researchers followed up 79 patients who had received SBI, reapplying the ASSIST and a questionnaire to evaluate the patients'/clients' satisfaction with the intervention they received. Results: In the first phase, it was found that most health professionals and social workers who completed the course applied the SBI in their work and felt very motivated to do it. In the second phase of the study, at a 3-month follow-up, most patients had significantly reduced their ASSIST scores in respect of alcohol and cocaine/crack in relation to their baseline levels. Those patients classified by their ASSIST score as “suggestive of dependence” presented a significant reduction in their scores regarding alcohol, tobacco, and cocaine/crack, whereas those classified as “at risk” presented a reduction in respect of alcohol problems only. Patients associated changes in their substance use with the SBI received. Conclusions: A reduction in substance use–related problems was associated with the SBI applied by the health professionals or social workers trained by the DL course SUPERA. Two significant limitations of this study were the small number of participants (professionals and patients in the follow-up) and the absence of a control group in the second phase of the study.

The relationship between self-compassion and the risk for substance use disorder

ObjectiveThis study explored the relationship between substance use disorder risk and self-compassion and posits a model for how the two are related through the mitigation of suffering. MethodStudy participants were recruited using social media to complete an online survey that included a basic socio-demographic survey and two validated instruments, the Self-Compassion Survey and the National Institute on Drug Abuse (NIDA) Alcohol Smoking and Substance Involvement Screening Test (ASSIST), which screens for substance use disorder (SUD) risk. Established cut scores for ASSIST were used to divide participants into low, moderate and high-risk groups. ResultsParticipants (n=477) were 31 years old on average, almost evenly split by gender, mostly non-Hispanic white, slightly more likely to be single and to hold an Associate’s degree or higher. Overall, 89% of participants reported using drugs and/or alcohol in their lifetime. SUD risk was distributed between low risk (52%), moderate risk (37%) and a smaller percentage of high risk (11%). Self-compassion was inversely related to SUD risk. The low risk group had a higher mean self-compassion score (M=2.86, SD=0.75) than the people who were high risk (M=2.25, SD=0.61) (t(298)=5.58 p<0.0001). Bivariate Pearson correlations showed strong associations between high risk and all self-compassion subscales, as well as low risk and five of the subscales. ConclusionsThis study suggests SUD risk has an inverse relationship to self-compassion. Raising self-compassion may be a useful addition to substance use disorder prevention and treatment interventions.

A cross-sectional study examining associations between substance use frequency, problematic use and STIs among youth living with HIV

ObjectivesThis study sought to examine the prevalence of STIs and whether substance use frequency and/or problematic use—specifically alcohol, marijuana and other drugs—was associated with having an STI diagnosis among youth...

Alcohol and tobacco use and the diseases treated in general practice.

To characterize the use of alcohol and tobacco and correlate both to the diseases of outpatients in a general practice outpatient clinic. The ASSIST (Alcohol, Smoking and Substance Involvement Screening Test) questionnaire was answered by 300 randomly chosen subjects assigned to different groups according to the diseases being treated at the Outpatient General and Teaching Clinic of the Department of Internal Medicine, Hospital das Clínicas of the University of São Paulo's School of Medicine (HC-FMUSP, in the Portuguese acronym), São Paulo, Brazil. The consumption of tobacco and alcohol was characterized and its correlation with the groups of diseases being treated was calculated using Chi-square and Pearson test statistics. Compared to alcohol, tobacco use was more prevalent, more intense and showed more health-, social-, legal- and financial-related damage. Tobacco smoking presented a positive significant (p<0.0001) correlation with respiratory diseases. According to the questionnaire's criteria, few alcohol users would be referred to clinical interventions in comparison to smokers. Respiratory diseases and tobacco use were well correlated based on the ASSIST questionnaire. The preventive value of the questionnaire was more evident in relation to tobacco than alcohol consumption.

Substance Use among a Sample of Healthcare Workers in Kenya: A Cross-Sectional Study

ABSTRACTThis study describes reported substance use among Kenyan healthcare workers (HCWs), as it has implications for HCWs’ health, productivity, and their ability and likelihood to intervene on substance use. The Alcohol Smoking and Substance Involvement Screening Test (ASSIST) was administered to a convenience sample of HCWs (n = 206) in 15 health facilities. Reported lifetime use was 35.8% for alcohol, 23.5% for tobacco, 9.3% for cannabis, 9.3% for sedatives, 8.8% for cocaine, 6.4% for amphetamine-like stimulants, 5.4% for hallucinogens, 3.4% for inhalants, and 3.9% for opioids. Tobacco and alcohol were also the two most commonly used substances in the previous three months. Male gender and other substance use were key predictors of both lifetime and previous three months’ use rates. HCWs’ substance use rates appear generally higher than those seen in the general population in Kenya, though lower than those reported among many HCWs globally. This pattern of use has implications for both HCWs and their clients.

Prevalencia de la hipertensión arterial y factores asociados en trabajadores de la Plaza Minorista José María Villa, Medellín

Objetivo: determinar la prevalencia de HTA en trabajadores de la Plaza Minorista y su distribución según condiciones sociodemográficas y cardiovasculares, Medellín 2015. Materiales y métodos: estudio transversal en 399 individuos, se hizo evaluación médica general y se aplicó una encuesta con variables socio-demográficas, antropométricas, ASSIST (Alcohol, Smoking and Substance Involvement Screening Test) e IPAQ (International Physical Activity Questionnaire). Se determinó la prevalencia global de HTA y otros riesgos cardiovasculares como obesidad, sobrepeso, sedentarismo y consumo de psicoactivos. Se estimó la prevalencia específica de HTA según variables demográficas y de riesgo cardiovascular. La confusión se cuantificó con regresión logística. Resultados: la prevalencia de HTA fue 35,1%; sobrepeso 40,1%, obesidad visceral 59,9%, sedentarismo 57,6%, tabaquismo 22,8%, alcoholismo 33,3% y antecedentes familiares de HTA 36,8%, de diabetes 30,1% y de dislipidemias 23,8%. La HTA presentó asociación con la edad, el sexo, los antecedentes personales de diabetes, la obesidad visceral, el grado educativo y el IMC. Conclusión: se halló una elevada prevalencia de HTA siendo los hombres y los obesos los subgrupos con una mayor ocurrencia; esto es útil para orientar esfuerzos investigativos y sanitarios en grupos similares.

Treatment Needs for Psychoactive Substance Use Disorders among Outpatients with Severe Mental Illness (SMI): A Comparative Study

Introduction: Research has shown that persons with schizophrenia and bipolar affective disorder constitute a significant proportion of patients with severe mental illnesses who have a risk of substance use disorders. There are few previous studies directly comparing level of risk for drug related adverse treatment outcomes and treatment needs for substance use disorders in these two disorders. The aim of the present study was to compare level of risk and treatment needs for substance use disorders between patients with schizophrenia and those with bipolar affective disorder. Methods: Equal number of participants (n = 75 per group) with SCHIZ and BAD at the outpatient clinic of the Neuropsychiatric Hospital Aro were interviewed with a socio-demographic questionnaire and the Alcohol smoking and substance involvement screening test (ASSIST). Result: Patients with bipolar disorder had higher risk for adverse effects of pain medication use, while schizophrenia patients had higher risk of adverse effects of tobacco, cannabis, stimulants, alcohol and sedatives. Age, sex, marital status and level of education had significant associations with elevated risk for psychoactive substance use disorders. Conclusions: Adverse treatment outcomes related to psychoactive substance use among individuals with severe mental disorders remain a burden in patient care. Routine screening for substance use at the out-patient department should evaluate risk for adverse effects of these substances and not only substance dependence.

Screening and brief intervention for low risk drug use in primary care: a pilot randomized trial

Material and methods We randomly assigned participants identified by screening with Alcohol Smoking and Substance Involvement Screening Test (ASSIST) drug specific scores of 2 or 3 (consistent with low risk drug use) to: no BI, a brief negotiated interview (BNI), or an adaptation of motivational interviewing (MOTIV). BNI was a 10-15 minute structured interview conducted by health educators. MOTIV was ?45 minutes with an optional booster conducted by trained master’s-level counselors. Primary outcome was number of days use of self-identified main drug in the past 30 as determined by validated calendar method at 6 months. Analyses were performed using negative binomial regression adjusted for baseline use and main drug.