Detection Of Substance Use Disorders Research Articles

ЗАБОЛЕВАЕМОСТЬ НАРКОМАНИЕЙ И АЛКОГОЛИЗМОМ В РОССИЙСКОЙ ФЕДЕРАЦИИ В ПЕРВЫХ ДВУХ ДЕСЯТИЛЕТИЯХ XXI ВЕКА. ДИНАМИКА И ОСНОВНЫЕ ТЕНДЕНЦИИ

Substance use disorders, despite their steady decline over the first 20 years of the 21st century, still remain one of the most important medical and social problems of modern times. Significant changes have been made both in the detection of substance use disorders and in the structure of the consumption of psychoactive substances. Purpose. To analyze dynamics in incidence of alcoholism and drug addiction in the Russian Federation as a whole and in the federal districts as well as to evaluate changes in the pattern of mental and behavioral disorders associated with psychoactive substance use. Material and methods. A retrospective analysis of the incidence of alcoholism and drug addiction, as well as the use of psychoactive substances with harmful consequences, was carried out in dynamics over the period from 2000 to 2020. Information for the analysis was obtained from the forms of the federal state statistical observation No. 11 "Information on the incidence of substance use disorders" for the indicated years. Information about the population size was obtained from the collections of the Federal State Statistics Service. Evaluation of relative values, including extensive and intensive coefficients, was carried out. Results. In general, in Russia, incidence of substance use disorders decreased 3.8 times from 2000 to 2020. However, some federal districts show deviations from certain trends observed in the Russian Federation. There has been a steady downward trend in the detection rate of alcoholism since 2003, which is accounted for by the anti-alcohol campaign launched at that time. Since 2000, there has been a sharp decline in drug addiction due to decreased number of opiate users. During the period under study, a number of bursts of growth in the drug addiction detection rate has been registered, associated with the appearance of desomorphine in 2005, and “designer” drugs and psychostimulants later on.

Substance use disorders in pregnancy: clinical, ethical, and research imperatives of the opioid epidemic: a report of a joint workshop of the Society for Maternal-Fetal Medicine, American College of Obstetricians and Gynecologists, and American Society of Addiction Medicine

Substance use disorders in pregnancy: clinical, ethical, and research imperatives of the opioid epidemic: a report of a joint workshop of the Society for Maternal-Fetal Medicine, American College of Obstetricians and Gynecologists, and American Society of Addiction Medicine

Family substance use screening: less to hide, more to gain.

A relentless rise in undertreated or untreated substance use disorders highlights the magnitude of the challenge the society is facing and a critical need to identify evidence-based, practical approaches in order to effectively screen people at high risk for unhealthy alcohol use, tobacco and drug use, increase early detection of substance use disorders, and offer the proper care they need. The Family CAGE (an acronym of four questions on alcohol use) is a brief questionnaire adapted from the original CAGE questionnaire devised by Frank et al1 and studied by Basu et al2, in this issue under a format encompassing drug use (AID=Adapted to Include Drugs). The study examines the validity and associated characteristics of the questionnaire for the diagnosis of alcohol and other substance use disorders as well as the inter-rater reliability between one family member and the substance user. The results were drawn from a cross-sectional analysis of two samples: treatment seeking substance-using patients, and individuals receiving outpatient psychiatric treatment while not pursuing treatment for substance use disorders. In both groups, the scores of the Family CAGE-AID and the traditional CAGE-AID questionnaires were significantly correlated. In the psychiatric sample, a correlation between the scores of the questionnaire and ICD-10 symptom score was observed, along with a moderate but significant agreement between the scores of substance users and family members. Family CAGE-AID was found to be sensitive and specific for the diagnosis of substance dependence formulated using ICD-10 criteria2. There are a few points to consider. Because of the design of the study, family members’acceptance of the questions about other members’ alcohol and drug use problems is unknown, which needs further study. The authors acknowledged that a limited range of substance use diagnoses and disease severity in the study sample limited the generalizability of study findings, and that psychiatric evaluation was not performed to control for the quality of responses among participating relatives. However, the findings demonstrate the practicality and potential utility of a family screen instrument for alcohol and drug use problems. Among future applications, the involvement of multiple family members in the interview, and confirmation studies in large samples at the primary care level and within different age ranges should be considered. Following evaluation, data gathered on interventions outcome and follow up assessment will be of interest.

EPA-0934 -Personal determinants of addictive behavior in naval institution students

The increase of substance use disorders (SUD) including alcoholism was observed in military population in many countries. The aim of the study was to determine the personality determinants that contribute to the development of various forms of addictive behavior in naval institution students. Screening method surveyed 260 students. For the risk detection of SUD (CAGE-AID, Fagerstrom test) and behavior addictions (Killinger workaholism test, 20 questions of Gambler Anonymous society, The Exercise Addiction Inventory, K.Young Internet-addiction questionnaire) were used. To study the personality characteristics Kettell questionnaire, ‘Deviant Behavior Tendency’ test and V. Rusalov questionnaire for Individuality Formal Dynamic Properties of were utilized. The study found the risk of SUD in the half of naval institution students and one quarter had a high risk level. Half of the students had tobacco dependence. The risk of behavior addictions does not exceed the population level. A high correlation between the risk of SUD and behavioral addictions was found. Personal characteristics like dominance in combination with uneasiness and courage, together with low emotional sensitivity were observed to be psychological determinants of addictive behavior. It is required to set up special programs to reduce the SUD risk in naval students.

The Utility of the SASSI‐3 in Early Detection of Substance Use Disorders in Not Guilty by Reason of Insanity Acquittees: An Exploratory Study

Previous studies have shown the Substance Abuse Subtle Screening Inventory‐3 (G. Miller, 1999) to be valid in classifying substance use disorders in forensic and mentally ill populations. The authors found that it also correctly classified substance use disorders in the understudied not guilty by reason of insanity population.

Identification of mental disorders in an in-patient prison psychiatric unit: Examining the criterion-related validity of the Personality Assessment Inventory.

Identifying inmates with mental disorders is a crucial function of correctional mental health services. This study examined the utility of several theoretically relevant scales and subscales of the Personality Assessment Inventory (PAI; Morey, 1991, 2007) to identify various broad diagnostic categories (i.e., mood, psychotic, and substance use disorders) in a sample of prisoners in an inpatient psychiatric facility (N 57). Results indicated moderate effect sizes and classification accuracy for most but not all PAI scales and subscales. Experimental scales for the detection of substance use disorders performed worse than the PAI Drug Problems scale in isolation.

Schizophrenia and Co-Occurring Substance Use Disorder

Schizophrenia and Co-Occurring Substance Use Disorder

How Are Substance Use Disorders Addressed in VA Psychiatric and Primary Care Settings? Results of a National Survey

This study examined interventions for substance use disorders within the Department of Veterans Affairs (VA) psychiatric and primary care settings. National random samples of 83 VA psychiatry program directors and 102 primary care practitioners were surveyed by telephone. The survey assessed screening practices to detect substance use disorders, protocols for treating patients with substance use disorders, and available treatments for substance use disorders. Respondents reported extensive contact with patients with substance use problems. However, a majority reported being ill equipped to treat substance use disorders themselves; they usually referred such patients to specialty substance use disorder treatment programs. Offering fewer specialty substance use disorder services within the VA may be problematic: providers can refer patients to specialty programs only if such programs exist. Caring for veterans with substance use disorders may require increasing the capacity of and establishing new specialty programs or expanding the ability of psychiatric programs and primary care practitioners to provide such care.

Datapoints: detection of substance use disorders in veterans affairs primary care clinics.

1326 I primary care providers are being called on to screen for atrisk substance use. The literature documents the continuing struggle in primary care to incorporate such screening into routine care (1,2). The objective of this study was to investigate patterns of diagnosis of substance use disorders in Department of Veterans Affairs (VA) primary care clinics over the past several years. Specifically, we wanted to determine whether the mandatory implementation of the Prevention Index in 1999 had an impact on rates of diagnosis of substance use disorders. The Prevention Index includes a screen for at-risk drinking. Data on all primary care visits were gathered from the VA’s national outpatient service use database for five fiscal years—1997 through 2001. All visits are coded with a primary diagnosis and up to ten secondary diagnoses. The secondary diagnoses indicate additional problems to be addressed during the visit and complicating factors associated with the primary diagnosis. Detection of Substance Use Disorders in Veterans Affairs Primary Care Clinics

Psychometric evaluation of the alcohol use disorders identification test and short drug abuse screening test with psychiatric patients in India.

The Alcohol Use Disorders Identification Test (AUDIT) and the short Drug Abuse Screening Test (DAST-10) are brief self-report screens for alcohol and drug problems that have not been evaluated for use with psychiatric patients in developing countries. This study was designed to evaluate the factor structure, reliability, validity, and utility of the AUDIT and the DAST-10 in an Indian psychiatric hospital. Consecutive inpatient admissions from April to December 2001 were sampled. Patients were diagnosed with substance use disorders or psychiatric disorders according to ICD-10 criteria. All patients completed both the AUDIT and the DAST-10 during their intake evaluation. Of the 2286 admissions to the hospital, 1349 were enrolled in the study (30% women); 361 patients (27%) had primary substance use disorders and 988 patients (73%) had primary psychiatric disorders. Both the AUDIT and the DAST-10 were unidimensional and internally consistent. Total scores significantly differentiated the subsamples with primary substance use from those with primary psychiatric disorders (p <.0001). Using cutoff scores of >/= 8 on the AUDIT and >/= 3 on the DAST-10, only 10% (N = 100) of the psychiatric subsample exceeded either cutoff, whereas 99% (N = 358) of the addiction treatment subsample exceeded 1 or both cutoffs. Within the psychiatric subsample, 77% (N = 65) of the patients who were identified as high risk on the AUDIT did not receive an additional alcohol use disorder diagnosis at discharge, and 59% (N = 16) of those identified as high risk on the DAST-10 did not receive an additional discharge diagnosis of drug use disorder. The AUDIT and the DAST-10 demonstrate strong psychometric properties when used in an Indian psychiatric hospital. Routine use of these brief screens can facilitate detection of substance use disorders among psychiatric patients.

Detection of substance use disorders in patients presenting with depression

Comorbidity between substance use disorders and major depression may complicate the treatment and adversely affect the outcome of either disorder. This study examines the frequency with which patients presenting with depression are evaluated for a substance use disorder in a university‐based family medicine residency program. A retrospective chart review was performed to identify 200 patients age 18 and older, seen between June 1, 1989, and June 1, 1999, who were diagnosed with depression (DSM IV code 300.4 or 311.0). The records were divided into two strata based on whether they were seen by resident or faculty physicians. The records were then reviewed for evidence of substance use screening. The overall percentage of patients with depression and evaluated for substance use disorders was calculated, and further stratified as to gender, age, previous psychiatric diagnosis, and previous substance use disorder diagnosis. Family physicians evaluated outpatients with a diagnosis of depression for substance use disorders only 24.5% of the time. Faculty evaluated depressed patients 18%, compared to residents doing so in 31 % of patients. Male patients were evaluated 34.7% as compared to 21.2 % of females. Patients over age 70 were screened at a rate of only 10.7%. Given the observed prevalence of substance use disorders in patients with a diagnosis of depression is between 40 and 50%, our finding that our depressed patients were evaluated for substance use disorders only 24.5% of the time, suggests that family physicians may be missing a significant number of patients with comorbid disease.

The Prevalence and Detection of Substance Use Disorders among Inpatients Ages 18 to 49: An Opportunity for Prevention

Background.Previous studies have found that substance use disorders are prevalent among inpatients of general medical hospitals. These studies were limited in the validity of their measures, their failure to distinguish between current and lifetime disorders, or their lack of attention to drugs other than alcohol.Methods.The current study used validated diagnostic instruments to measure current and lifetime alcohol and other drug abuse and dependence among patients ages 18 through 49. Additionally, this study assessed the sensitivity and specificity of four substance abuse screening questions. Patients were recruited from the general medical, general surgery, and orthopedics services of a university hospital in Madison, Wisconsin. The sample included 363 patients, or 86.4% of those recruited.Results.The current and lifetime prevalence rates of substance use disorders were 21.8 and 49.6%, respectively. The prevalence rates of current problems were 16.3%, alcohol only; 2.5%, other drugs only; and 3.0%, alcohol and other drugs. Males had nearly a 30% current prevalence of current substance use disorders. The CAGE Questions Adapted to Include Drugs exhibited 70.9% sensitivity and 75.7% specificity.Conclusions.At one hospital, and perhaps at others, an alcohol and drug screening, assessment, and intervention program may have the potential to prevent future health and social problems.

Detection of Substance Use Disorders among Psychiatric Inpatients

This study examines the utility of the Addiction Severity Index (ASI) for detecting psychoactive substance use disorders (PSUDs) among psychiatric inpatients. Four hundred thirty-five inpatients at two inner-city psychiatric hospitals completed the ASI and the Structured Clinical Interview for DSM-III-R (SCID). Receiver operating characteristic (ROC) analysis assessed the optimal threshold ASI alcohol and drug composite scores to detect DSM-III-R PSUDs. The correlations of both the ASI alcohol and drug composite scores with their corresponding DSM-III-R PSUD categories were significant (p<.0001). However, the ROC analysis revealed that the ASI misses approximately 20% of SCID-positive PSUD cases. Specificity of the ASI, on the other hand, is quite good (95% to 98%), and optimal ASI threshold scores to rule out a PSUD among these patients are identified. The results also support the sensitivity of these patients to the toxic effects of illicit substance use.

Detection of substance use disorders in severely mentally ill patients

Severe mental illness is frequently complicated by substance use disorder. Approximately half of the severely mentally ill patients treated in acute care psychiatric settings have abused one or more of these substances. Despite the high rate of comorbidity, substance use disorders are generally not detected in acute care psychiatric settings, leading to incorrect diagnoses and ineffective treatments. The reasons for nondetection are complex, and research is needed to refine instruments and procedures for the detection of substance abuse in the severely mentally ill population. Nevertheless, clinicians can make better use of existing techniques of multimodal assessment to increase significantly the rate of accurate detection.