The Severity of Dependence Scale detects medication misuse and dependence among hospitalized older patients

Objective: Investigate the psychometric properties of the Severity of Dependence Scale (SDS) for codeine and its association with aberrant codeine related behaviors.Design: A voluntary and uncompensated cross-sectional online survey.Setting: Online population (≥18 years).Respondents: Two hundred and eighty-six respondents (66% women) who had used codeine containing medicines in the last 3 months and were living in the UK.Results: Of the respondents (mean age = 35.4 years, SD = 12.5), more than half were employed. Only 3.5% respondents reported no income. The majority of respondents (45.1%) primarily obtained prescription-only codeine from a consultation with a health professional, whilst 40.9% mainly purchased “over-the-counter” codeine containing medicines in a pharmacy without a medical prescription. Principal component analysis indicated a single factor solution accounting for 75% of the variance. Factor loadings ranged from 0.83 to 0.89. Cronbach's Alpha was high (α = 0.92). Several behaviors relating to codeine use were found to significantly predict probable codeine dependence. These included: daily codeine use in the last 3 months (OR = 66.89, 95% CI = 15.8–283.18); tolerance to codeine (OR = 32.14, 95% CI = 13.82–74.75); problems with role responsibility due to intoxication (OR = 9.89, 95% CI = 4.95–19.78); having sought advice on the internet to manage codeine use (OR = 9.56, 95% CI = 4.5–20.31); history of alcohol or drug treatment (OR = 3.73, 95% CI = 1.88–7.43).Conclusions: The SDS was acceptable and feasible to use to assess probable psychological codeine dependence in an online sample of people using codeine containing medicines. SDS scores were associated with behaviors known to be indicators of codeine dependence. Studies are needed in well-defined populations of people who use codeine to test the different aspects of psychometry of the scale compared against “gold standard” criterion [a diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)].

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Sociodemographic, clinical and pharmacological profiles of medication misuse and dependence in hospitalised older patients in Norway: a prospective cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2019-031483 ◽

2019 ◽

Vol 9 (9) ◽

pp. e031483 ◽

Cited By ~ 2

Author(s):

Socheat Cheng ◽

Tahreem Ghazal Siddiqui ◽

Michael Gossop ◽

Espen Saxhaug Kristoffersen ◽

Christofer Lundqvist

Keyword(s):

Pain Intensity ◽

Older Patients ◽

Adverse Drug Events ◽

Cross Sectional Study ◽

University Hospital ◽

Sectional Study ◽

Cross Sectional ◽

Medication Misuse ◽

Factors Associated ◽

Concurrent Use

ObjectivesTimely recognition of medication misuse and dependence is crucial to avoid both adverse drug events and increasing health expenditure. Yet the detection of these disorders in older people remains challenging due to the paucity of evidence on characteristics of patients at risk. This study investigates sociodemographic, pharmacological and clinical characteristics and factors associated with prolonged medication use, misuse and dependence in hospitalised older patients, focusing on three commonly prescribed central nervous system depressants (CNSDs): opioid analgesics, benzodiazepines and z-hypnotics.DesignA prospective, cross-sectional study complying with the Strengthening the Reporting of Observational Studies in Epidemiology guidelines.SettingSomatic departments of the Akershus University Hospital, Norway.Participants246 patients aged 65–90 were included.Outcome measuresProlonged use was defined as using CNSDs for ≥4 weeks. Misuse and dependence were assessed with the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition criteria for substance abuse and dependence. We used descriptive statistics to report patients’ characteristics and logistic regression to demonstrate factors associated with prolonged use, and misuse or dependence.ResultsForty per cent of participants reported using CNSDs for ≥4 weeks. The odds of prolonged use were higher for patients aged 75–84 (OR=2.32, 95% CI 1.16 to 4.65) and ≥85 (OR=3.33, 95% CI 1.25 to 8.87) vs <75 years, for pain intensity (OR=1.02, 95% CI 1.01 to 1.04), and polypharmacy versus no polypharmacy (OR=5.16, 95% CI 2.13 to 12.55). The odds were lower for patients who completed secondary education (OR=0.33, 95% CI 0.13 to 0.83) compared with those with only basic education. Factors associated with misuse or dependence were pain intensity (OR=1.02, 95% CI 1.01 to 1.04) and concurrent use of ≥2 CNSDs (OR=3.99, 95% CI 1.34 to 11.88).ConclusionCNSD overuse is prevalent among hospitalised older patients, despite clear guidelines and recommendations. Our findings underline a need for stronger focus on responsible prescribing, timely detection and prevention of this issue, with special attention towards older patients, those with enhanced pain, polypharmacy and/or concurrent use of several CNSDs.Trial registration numberNCT03162081.

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Validity of the Severity of Dependence Scale (SDS) Construct Applying the Item Response Theory to a Non-Clinical Sample of Heroin Users

Substance Use & Misuse ◽

10.1080/10826080701801543 ◽

2008 ◽

Vol 43 (7) ◽

pp. 919-935 ◽

Cited By ~ 10

Author(s):

Francisco González-Saiz ◽

Óscar M. Lozano ◽

Rosario Ballesta ◽

Teresa Silva ◽

Maria Teresa Brugal ◽

...

Keyword(s):

Item Response Theory ◽

Item Response ◽

Clinical Sample ◽

Response Theory ◽

Heroin Users ◽

Dependence Scale ◽

Severity Of Dependence Scale

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The reliability and validity of the Severity of Dependence Scale for detecting cannabis dependence in psychosis

Addiction ◽

10.1111/j.1360-0443.2006.01669.x ◽

2007 ◽

Vol 102 (1) ◽

pp. 35-40 ◽

Cited By ~ 26

Author(s):

L. Hides ◽

S. Dawe ◽

R. McD. Young ◽

D. J. Kavanagh

Keyword(s):

Reliability And Validity ◽

Cannabis Dependence ◽

Dependence Scale ◽

Severity Of Dependence Scale

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The Severity of Dependence Scale had high sensitivity and specificity for detecting benzodiazepine dependence

Evidence-Based Mental Health ◽

10.1136/ebmh.3.4.119 ◽

2000 ◽

Vol 3 (4) ◽

pp. 119-119

Author(s):

F. D Law

Keyword(s):

Sensitivity And Specificity ◽

High Sensitivity ◽

Benzodiazepine Dependence ◽

Dependence Scale ◽

Severity Of Dependence Scale

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Test-retest reliability of the Severity of Dependence Scale

Addiction ◽

10.1080/09652149738439 ◽

1997 ◽

Vol 92 (3) ◽

pp. 353-353 ◽

Cited By ~ 3

Author(s):

Michael Gossop ◽

David Best ◽

John Marsden ◽

John Strang

Keyword(s):

Retest Reliability ◽

Dependence Scale ◽

Test Retest Reliability ◽

Severity Of Dependence Scale

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Choosing a Cut-Off on the Severity of Dependence Scale for Ecstasy Use

The Open Addiction Journal ◽

10.2174/1874941001104010013 ◽

2011 ◽

Vol 4 (1) ◽

pp. 13-14 ◽

Cited By ~ 3

Author(s):

Raimondo Bruno

Keyword(s):

Dependence Scale ◽

Severity Of Dependence Scale

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Validity of self-reported assessment of Severity of Dependence Scale in Medication-Overuse Headache

Scandinavian Journal of Pain ◽

10.1515/sjpain-2019-0022 ◽

2019 ◽

Vol 19 (4) ◽

pp. 837-841 ◽

Cited By ~ 1

Author(s):

Espen Saxhaug Kristoffersen ◽

Jūratė Šaltytė Benth ◽

Jørund Straand ◽

Michael Bjørn Russell ◽

Christofer Lundqvist

Keyword(s):

Medication Overuse ◽

Controlled Trial ◽

Medication Overuse Headache ◽

Self Assessment ◽

Web Based ◽

Withdrawal Therapy ◽

Dependence Scale ◽

Self Administered Questionnaire ◽

Population Controls ◽

Severity Of Dependence Scale

Abstract The interview-based Severity of Dependence Scale (SDS) predicts the outcome of withdrawal therapy in Medication-Overuse Headache (MOH). We aimed to compare the interview-based SDS with a self-administrated written version. Fifty-three MOH patients, 19 chronic headache patients without medication overuse and 25 population controls were recruited from a previous randomized controlled trial. The SDS was scored in a telephone interview by headache experts, further, the participants filled in the SDS as a part of a self-administered questionnaire. The SDS assesses scores dependence through five questions, each scored from 0 to 3. A score of ≥5 is associated with MOH. Mean SDS scores were 2.8 (SD 3.0) vs. 3.1 (SD 2.9), p = 0.12, for the interview vs. the self-reported questionnaire, with a correlation 0.78. There was a non-significant bias of 0.32 (95% limits of agreement of −3.6; 4.2) between the two methods in the Bland-Altman analysis. A self-reported SDS questionnaire can be used, and may yield valuable information as a screening tool prior to headache consultations or studies. The possibilities of designing web-based self-treatment tools based on SDS self-assessment and brief intervention may be a future approach for a large group of patients.

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