Screening for Unhealthy Alcohol and Drug Use in General Medicine Settings

2022 ◽  
Vol 106 (1) ◽  
pp. 13-28
Author(s):  
Jennifer McNeely ◽  
Leah Hamilton
2018 ◽  
Vol 23 (1) ◽  
pp. 190-200 ◽  
Author(s):  
Onyema Ogbuagu ◽  
Brandon D. L. Marshall ◽  
Perry Tiberio ◽  
Adedotun Ogunbajo ◽  
Lydia Barakat ◽  
...  

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Joshua W. Elder ◽  
Evan F. Wu ◽  
James A. Chenoweth ◽  
James F. Holmes ◽  
Aman K. Parikh ◽  
...  

Background. Screening for unhealthy alcohol and drug use in the emergency department (ED) can be challenging due to crowding, lack of privacy, and overburdened staff. The objectives of this study were to determine the feasibility and utility of a brief tablet-based screening method in the ED and if patients would consider a face-to-face meeting with a certified alcohol and drug counselor (CADC) for more in-depth screening, brief intervention, and referral to treatment (SBIRT) helpful via this interface. Methods. A tablet-based questionnaire was offered to 500 patients. Inclusion criteria were age ≥18, Emergency Severity Index 2–5, and English comprehension. Subjects were excluded if they had evidence of acute intoxication and/or received sedating medication. Results. A total of 283 (57%) subjects were enrolled over a 4-week period, which represented an increase of 183% over the monthly average of patients referred for SBIRT by the CADC prior to the study. There were 131 (46%) who screened positive for unhealthy alcohol and drug use, with 51 (39%) and 37 (28%) who screened positive for solely unhealthy alcohol use and drug use/drug use disorders, respectively. There were 43 (33%) who screened positive for combined unhealthy alcohol and drug use. Despite willingness to participate in the tablet-based questionnaire, only 20 (15%) with a positive screen indicated via the tablet that a face-to-face meeting with the CADC for further SBIRT would be helpful. Conclusion. Brief tablet-based screening for unhealthy alcohol and drug use in the ED was an effective method to increase the number of adult patients identified than solely by their treating clinicians. However, only a minority of subjects screening positive using this interface believed a face-to-face meeting with the CADC for further SBIRT would be helpful.


2019 ◽  
Vol 96 (3) ◽  
pp. 184-188
Author(s):  
J Carlo Hojilla ◽  
Julia Marcus ◽  
Jonathan E Volk ◽  
Wendy Leyden ◽  
C Bradley Hare ◽  
...  

ObjectivesPeople with HIV (PWH) have a high burden of bacterial sexually transmitted infections (STIs). We examined the relationship of alcohol and drug use and partner pre-exposure prophylaxis (PrEP) use to STI prevalence in a cohort of PWH with a history of unhealthy alcohol use.MethodsWe analysed data from a primary care-based alcohol intervention study at Kaiser Permanente Northern California (KPNC). Participants were recruited between April 2013 and May 2015 and were followed for up to 24 months. We linked participant responses to questions from the 24 month follow-up interview, including alcohol and drug use and partner PrEP use, with STI test results (ie, syphilis, chlamydia, gonorrhoea) in the KPNC electronic health record. Prevalence ratios (PR) were estimated using Poisson models fitted with robust variance estimators to evaluate the association of substance use and partner use of PrEP with STIs.ResultsIn the analytic sample (n=465), the median age was 52 years (IQR 45–59); 67% were white; 95% were men who have sex with men. Thirty-two per cent of participants had HIV-positive partners only; 31% had HIV-negative partners with at least one on PrEP in the previous year and 37% had HIV-negative partners without any on PrEP. Twenty-three per cent reported alcohol and drug use prior to sex in the last 6 months. Eight per cent of participants had an STI. Partner PrEP use (adjusted PR (aPR) 2.99 (95% CI 1.11 to 8.08)) was independently associated with higher STI prevalence. Participants who reported use of alcohol (aPR 1.53 (0.61 to 3.83)), drugs (aPR 1.97 (0.71 to 5.51)) or both (aPR 1.93 (0.75 to 4.97)) prior to sex had a higher STI prevalence.ConclusionsThe higher prevalence of STIs among PWH with unhealthy alcohol use who have partners on PrEP suggests that this subgroup may be a high-yield focus for targeted outreach, STI screening and sexual health counselling.


2015 ◽  
Vol 30 (12) ◽  
pp. 1757-1764 ◽  
Author(s):  
Jennifer McNeely ◽  
Charles M. Cleland ◽  
Shiela M. Strauss ◽  
Joseph J. Palamar ◽  
John Rotrosen ◽  
...  

2019 ◽  
Vol 41 (3) ◽  
pp. 331-339 ◽  
Author(s):  
Sarah E. Wakeman ◽  
Grace Herman ◽  
Timothy E. Wilens ◽  
Susan Regan

2010 ◽  
pp. 847-874
Author(s):  
Michael F. Bierer ◽  
Richard Saitz

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