scholarly journals A Cascade of Care for Alcohol Use Disorder: Using 2015-2018 National Survey on Drug Use and Health Data to Identify Gaps in Care

2020 ◽  
Author(s):  
Carrie M. Mintz ◽  
Sarah M. Hartz ◽  
Sherri L. Fisher ◽  
Alex T. Ramsey ◽  
Elvin H. Geng ◽  
...  
Keyword(s):  
Health Care ◽  
Alcohol Use ◽  
Drug Use ◽  
Brief Intervention ◽  
Alcohol Use Disorder ◽  
Alcohol Misuse ◽  
Health Data ◽  
Health Care Settings ◽  
The Past ◽  
Cascade Of Care

ABSTRACTBackgroundAlthough effective treatments exist, alcohol use disorder (AUD) is undertreated. We used a cascade of care framework to understand gaps in care between diagnosis and treatment for persons with AUD.MethodsUsing 2015-2018 National Survey on Drug Use and Health data, we evaluated the following steps in the cascade of care: 1) prevalence of adults with AUD; 2) proportion of adults who utilized health care in the past 12 months; 3) were screened about alcohol use; 4) received a brief intervention about alcohol misuse; 5) received information about treatment for alcohol misuse; and 6) proportion of persons with AUD who received treatment. Analyses were stratified by AUD severity.ResultsOf the 171,766 persons included in the sample, weighted prevalence of AUD was 7.9% (95% CI 7.7-8.0%). Persons with AUD utilized health care settings at similar rates as those without AUD. Cascades of care showed the majority of individuals with AUD utilized health care and were screened about alcohol use, but the percent who received the subsequent steps of care decreased substantially. For those with severe AUD, 83.5% (CI: 78.3%-88.7%) utilized health care in the past 12 months, 73.5% (CI: 68.1%-78.9%) were screened for alcohol use, 22.7% (CI: 19.4%-26.0%) received a brief intervention, 12.4% (CI: 10%-14.7%) received information about treatment, and 20.5% (CI: 18%-23.1%) were treated for AUD. The greatest decrease in the care continuum occurred from screening to brief intervention and referral to treatment. More persons with severe AUD received treatment than were referred, indicating other pathways to treatment outside of the healthcare system.ConclusionsPersons with AUD utilize health care at high rates and are frequently screened about alcohol use, but few receive treatment. Health care settings-particularly primary care settings-represent a prime opportunity to implement pharmacologic treatment for AUD to improve outcomes in this high-risk population.

scholarly journals Evidence-based models of care for the treatment of alcohol use disorder in primary health care settings: protocol for systematic review

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Susan A. Rombouts ◽  
James Conigrave ◽  
Eva Louie ◽  
Paul Haber ◽  
Kirsten C. Morley
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Primary Health Care ◽  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Critical Appraisal ◽  
Models Of Care ◽  
Health Care Settings ◽  
Primary Health ◽  
Primary Health Care Settings

Abstract Background Alcohol use disorder (AUD) is highly prevalent and accounts globally for 1.6% of disability-adjusted life years (DALYs) among females and 6.0% of DALYs among males. Effective treatments for AUDs are available but are not commonly practiced in primary health care. Furthermore, referral to specialized care is often not successful and patients that do seek treatment are likely to have developed more severe dependence. A more cost-efficient health care model is to treat less severe AUD in a primary care setting before the onset of greater dependence severity. Few models of care for the management of AUD in primary health care have been developed and with limited implementation. This proposed systematic review will synthesize and evaluate differential models of care for the management of AUD in primary health care settings. Methods We will conduct a systematic review to synthesize studies that evaluate the effectiveness of models of care in the treatment of AUD in primary health care. A comprehensive search approach will be conducted using the following databases; MEDLINE (1946 to present), PsycINFO (1806 to present), Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL) (1991 to present), and Embase (1947 to present). Reference searches of relevant reviews and articles will be conducted. Similarly, a gray literature search will be done with the help of Google and the gray matter tool which is a checklist of health-related sites organized by topic. Two researchers will independently review all titles and abstracts followed by full-text review for inclusion. The planned method of extracting data from articles and the critical appraisal will also be done in duplicate. For the critical appraisal, the Cochrane risk of bias tool 2.0 will be used. Discussion This systematic review and meta-analysis aims to guide improvement of design and implementation of evidence-based models of care for the treatment of alcohol use disorder in primary health care settings. The evidence will define which models are most promising and will guide further research. Protocol registration number PROSPERO CRD42019120293.

scholarly journals Prevalence and correlates of non-daily and daily cannabis use among persons 15 years and older in South Africa: results of a national survey in 2017

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Shandir Ramlagan ◽  
Karl Peltzer ◽  
Supa Pengpid
Keyword(s):  
South Africa ◽  
Logistic Regression ◽  
Alcohol Use ◽  
Drug Use ◽  
Alcohol Use Disorder ◽  
Labour Force ◽  
Cannabis Use ◽  
Never Married ◽  
The Past ◽  
Male Sex

Abstract Background The study aimed to assess the prevalence and correlates of non-daily and daily cannabis use among persons 15 years and older in South Africa. Method In a national cross-sectional 2017 survey, 39,207 persons 15 years and older (Median = 34 years) responded to a questionnaire on cannabis use and health variables. Multinominal logistic regression was used to assess the determinants of nondaily and daily cannabis use among the general population and logistic regression for the determinants of daily cannabis use among active cannabis users. Results Results indicate that 5.0% of the participants engaged in non-daily and 2.8% in daily cannabis use in the past 3 months. In adjusted multinomial logistic regression analysis, male sex, Grade 8–11 education, Coloureds, alcohol use disorder, never married, and other drug use were positively associated with daily cannabis use while not in not labour force was negatively associated with daily cannabis use. Moreover, male sex, never married, alcohol use disorder, and other drug use were positively, while physical multimorbidity was negatively associated with nondaily cannabis use. In adjusted logistic regression, compared to nondaily cannabis users, daily cannabis users were more likely male and were less likely not in the labour force and were less likely using other drugs. Conclusion About one in ten participants had used cannabis in the past 3 months in South Africa. Several sociodemographic and health indicators were identified that were associated with non-daily and/or daily cannabis use.

scholarly journals Toward the prevention of alcohol use disorders: Overdrinking (unintentional binge drinking) in a community sample

2018 ◽  
Vol 5 (2) ◽  
pp. 205510291879270 ◽  
Author(s):  
F Michler Bishop ◽  
Jose Luis Rodriquez Orjuela
Keyword(s):  
United States ◽  
Pilot Study ◽  
Alcohol Use ◽  
Binge Drinking ◽  
Alcohol Use Disorder ◽  
Problem Drinking ◽  
Community Sample ◽  
Alcohol Use Disorders ◽  
The United States ◽  
The Past

Approximately 64,000,000 people in the United States report binge drinking at least once in the past month. Unlike overeating and oversleeping, “overdrinking”—defined as drinking more than a person intends to drink—does not exist in the literature. Terms such as binge and problem drinking do not consider the intent of the drinker. The results of this pilot study suggest that most people drink more than they intend to drink. Moreover, they also report often being surprised that they overdrank. Smartphones may help overdrinkers be less often surprised by overdrinking and may prevent drinkers from developing an alcohol use disorder.

scholarly journals Epidemiology of Alcohol Misuse and Illicit Drug Use Among Young People Aged 15–24 Years in Fishing Communities in Uganda

2020 ◽  
Vol 17 (7) ◽  
pp. 2401 ◽  
Author(s):  
Monica O. Kuteesa ◽  
Helen A. Weiss ◽  
Sarah Cook ◽  
Janet Seeley ◽  
Josephine N. Ssentongo ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Young People ◽  
Drug Use ◽  
Illicit Drugs ◽  
Alcohol Misuse ◽  
Illicit Drug ◽  
Illicit Drug Use ◽  
Older Age ◽  
Fishing Communities ◽  
Low Education

Background: We determined the prevalence of and risk factors for alcohol misuse and illicit drug use among young Ugandans in fishing communities, a recognised “key population” for human immunodeficiency virus (HIV) infection. Methods: We conducted a cross-sectional survey among young people (15–24 years) in fishing communities in Koome, Uganda, in December 2017–July 2018. Using Audio-Assisted Self-Interviewing, we collected data on socio-demographic characteristics and alcohol use, including the Alcohol Use Disorders Identification Test (AUDIT) and timeline follow-back calendar (TLFB). Blood samples were analysed for HIV, herpes simplex virus 2 (HSV2), and Phosphatidyl ethanol (PEth 16:0/18:1). Urine samples were analysed for illicit drugs. Results: Among 1281 participants (52.7% male, mean age 20 years), 659 (51.4%) reported ever drinking alcohol, 248 (19.4%) had 12-month-AUDIT ≥ 8, and 261 (20.5%) had whole-blood PEth 16:0/18:1 concentration ≥ 20 ng/mL, indicating significant consumption. In multivariable analyses, PEth 16:0/18:1 ≥ 20ng/mL, AUDIT ≥ 8 and binge drinking (≥6 standard drinks per drinking occasion in the previous month from TLFB) were all strongly associated with older age, low education, smoking, and HSV2. Illicit drug use prevalence was 5.2% and was associated with older age, low education, being single, and smoking. Conclusion: Levels of alcohol misuse were high among young people in fishing communities and associated with HSV2, a proxy for risky sexual behaviour. Alcohol and illicit drug harm reduction services and HIV prevention programs in Uganda should prioritise young fisherfolk.

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