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Drug And Alcohol Problems (drug + and_alcohol_problem)
Selected AbstractsValidation of the World Health Organization Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): report of results from the Australian siteDRUG AND ALCOHOL REVIEW, Issue 3 2005DAVID A. L. NEWCOMBE Abstract The concurrent, construct, discriminative and predictive validity of the World Health Organization's Alcohol Substance Involvement Screening Test (ASSIST) were examined in an Australian sample. One hundred and fifty participants, recruited from drug treatment (n = 50) and primary health care (PHC) settings (n = 100), were administered a battery of instruments at baseline and a modified battery at 3 months. Measures included the ASSIST; the Addiction Severity Index-Lite (ASI-Lite); the Severity of Dependence Scale (SDS); the MINI International Neuropsychiatric Interview (MINI-Plus); the Rating of Injection Site Condition (RISC); the Drug Abuse Screening Test (DAST); the Alcohol Use Disorders Identification Test (AUDIT); the Revised Fagerstrom Tolerance Questionnaire (RTQ); and the Maudsely Addiction Profile (MAP). Concurrent validity was demonstrated by significant correlations between ASSIST scores and scores from the ASI-lite, SDS, AUDIT and DAST; and significantly greater ASSIST scores for those with diagnoses of abuse or dependence. Construct validity was established by significant correlations between ASSIST scores and measures of risk factors for the development of drug and alcohol problems. Participants diagnosed with attention deficit/hyperactivity disorder or antisocial personality disorder had significantly higher ASSIST scores than those not diagnosed as such. Discriminative validity was established by the capacity of the ASSIST to discriminate between substance use, abuse and dependence. ROC analysis was able to establish cut-off scores for an Australian sample, with suitable specificities and sensitivities for most substances. Predictive validity was demonstrated by similarity in ASSIST scores obtained at baseline and at follow-up. The findings demonstrated that the ASSIST is a valid screening test for psychoactive substance use in individuals who use a number of substances and have varying degrees of substance use. [source] Characteristics and comorbidity of drug and alcohol-related emergency department presentations detected by nursing triage textADDICTION, Issue 5 2010Devon Indig ABSTRACT Introduction This study used nursing triage text to detect drug- and alcohol-related emergency department (ED) presentations and describe their patient and service delivery characteristics. Methods Data were reviewed for all ED presentations from 2004 to 2006 (n = 263 937) from two hospitals in Sydney, Australia. Each record included two nursing triage free-text fields, which were searched for more than 100 drug-related and more than 60 alcohol-related terms. Adjusted odds ratios were used to compare the characteristics of drug and alcohol-related ED presentations with all other ED presentation types. Results Just over 5% of ED presentations were identified as alcohol-related and 2% as drug-related. The most prevalent drug-related ED presentations specified were related to amphetamines (18%), heroin (14%), cannabis (14%) and ecstasy (12%), while nearly half (43%) were drug unspecified. Polydrug use was mentioned in 25% of drug-related and 9% of alcohol-related ED presentations, with the highest rate of polydrug use among ecstasy-related (68%) presentations. Drug- and alcohol-related ED presentations were significantly more likely than other ED presentations to have a mental health diagnosis, with the highest rates found among cannabis-related (OR = 7.6) or amphetamine-related (OR = 7.5) presentations. Conclusion The ED provides an opportunity for early intervention for patients presenting with comorbid drug and alcohol and mental health problems. Further research is needed to assess the prevalence of drug and alcohol problems in ED patients with mental health problems and to develop effective interventions in that setting. [source] Validation of the alcohol, smoking and substance involvement screening test (ASSIST)ADDICTION, Issue 6 2008Rachel Humeniuk ABSTRACT Aim The concurrent, construct and discriminative validity of the World Health Organization's Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) were examined in a multi-site international study. Participants One thousand and 47 participants, recruited from drug treatment (n = 350) and primary health care (PHC) settings (n = 697), were administered a battery of instruments. Measurements Measures included the ASSIST; the Addiction Severity Index-Lite (ASI-Lite); the Severity of Dependence Scale (SDS); the MINI International Neuropsychiatric Interview (MINI-Plus); the Rating of Injection Site Condition (RISC); the Drug Abuse Screening Test (DAST); the Alcohol Use Disorders Identification Test (AUDIT); the Revised Fagerstrom Tolerance Questionnaire (RTQ); and the Maudsley Addiction Profile (MAP). Findings Concurrent validity was demonstrated by significant correlations between ASSIST scores and scores from the ASI-Lite (r = 0.76,0.88), SDS (r = 0.59), AUDIT (r = 0.82) and RTQ (r = 0.78); and significantly greater ASSIST scores for those with MINI-Plus diagnoses of abuse or dependence (P < 0.001). Construct validity was established by significant correlations between ASSIST scores and measures of risk factors for the development of drug and alcohol problems (r = 0.48,0.76). Discriminative validity was established by the capacity of the ASSIST to discriminate between substance use, abuse and dependence. Receiver operating characteristic (ROC) analysis was used to establish cut-off scores with suitable specificities (50,96%) and sensitivities (54,97%) for most substances. Conclusions The findings demonstrated that the ASSIST is a valid screening test for identifying psychoactive substance use in individuals who use a number of substances and have varying degrees of substance use. [source] The Supervised Methadone and Resettlement Team nurse: an effective approach with opiate-dependent, homeless peopleINTERNATIONAL NURSING REVIEW, Issue 2 2001W. Mistral BSC. Abstract Homelessness and substance misuse have risen dramatically over the past 30 years in the UK. The role of the primary care nurse has been signalled as important in working with people who have drug and alcohol problems, and for improving the general health of homeless people. This article focuses on the role of the primary care nurse in a Supervised Methadone and Resettlement Team (SMART). The team works in central Bristol, in southwest England, with people who are homeless and using illegal opiates. The aim of this report is to provide descriptive information that demonstrates the value of the primary care nurse, working in a multiagency partnership, in dealing with the problems of this homeless population, many of whom have problems associated with illicit drug use. Client outcomes from a small sample of homeless persons are also described. [source] Psychological distress is associated with a range of high-priority health conditions affecting working AustraliansAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 3 2010Libby Holden Abstract Background: Psychological distress is growing in prevalence in Australia. Comorbid psychological distress and/or depressive symptoms are often associated with poorer health, higher healthcare utilisation and decreased adherence to medical treatments. Methods: The Australian Work Outcomes Research Cost-benefit (WORC) study cross-sectional screening dataset was used to explore the association between psychological distress and a range of health conditions in a sample of approximately 78,000 working Australians. The study uses the World Health Organization Health and Productivity Questionnaire (HPQ), to identify self-reported health status. Within the HPQ is the Kessler 6 (K6), a six-item scale of psychological distress which strongly discriminates between those with and without a mental disorder. Potential confounders of age, sex, marital status, number of children, education level and annual income were included in multivariate logistic regression models. Results: Psychological distress was significantly associated with all investigated health conditions in both crude and adjusted estimates. The conditions with the strongest adjusted association were, in order from highest: drug and alcohol problems, fatigue, migraine, CVD, COPD, injury and obesity. Conclusions: Psychological distress is strongly associated with all 14 health conditions or risk factors investigated in this study. Comorbid psychological distress is a growing public health issue affecting Australian workers. [source] Results from the 4th National Clients of Treatment Service Agencies census: changes in clients' substance use and other characteristicsAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 4 2002Fiona Shand Objective: The 2001 Clients of Treatment Service Agencies (COTSA) census, the fourth since 1990, was conducted to enable a comparison of the drug and alcohol-related problems being treated over an 11-year period. Method The 24-hour census was conducted on Wednesday 2 May 2001 in all Australian States and Territories. All agencies providing treatment for drug and alcohol problems in Australia were asked to provide demographic, treatment and substance use information about all clients treated on census day. The data were analysed with frequencies and basic descriptive statistics. Results: Of the agencies surveyed, 90.3% responded. The census suggests that, among the treatment population, the mean age of substance users has decreased and the proportion of clients who are women has increased. Treatment for opiate, cannabis and amphetamine problems increased; treatment for alcohol problems decreased. Substance use patterns differed according to sex, age, size of the population centre, and Indigenous status. Conclusions and implications: Changes among the treatment population reflect changes in demographics and substance use among the broader drug-using community, with the exception of the presentation of alcohol problems for treatment. The reasons for the apparent decline in treatment for alcohol problems are not clear, although a number of factors, such as changes in treatment strategies and facilities and relative increases in other substance use problems, are considered. Any decrease in treatment for a significant health problem such as alcohol use disorder will have considerable public health implications. 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