Identifying adolescents with alcohol use disorder: Optimal screening using the National Institute on Alcohol Abuse and Alcoholism screening guide

Unhealthy alcohol use: screening and behavioral counseling interventions

BACKGROUND

Despite the increase in daily alcohol intake in recent decades and the implementation of national health screenings, effective management strategies for alcohol consumption remain outdated. This review evaluates intervention studies on screening and behavioral counseling for unhealthy alcohol use, with the aim of enhancing the effectiveness of interventions and improving health outcomes.

METHODS

On the basis of the GRADE (Grading of Recommendations Assessment, Development, and Evaluation)- ADOLOPMENT framework, systematic reviews and randomized controlled trials were examined to investigate the effectiveness of screening and counseling interventions in reducing unhealthy alcohol use. Five key questions were generated, and an evaluation and quality assessment of existing systematic reviews and new evidence related to each key question were conducted.

RESULTS

Updating the U.S. Preventive Services Task Force and Cochrane 2018 reviews, we identified five new randomized trials that evaluated screening and counseling interventions for unhealthy alcohol use. For Key Question 2, the sensitivity and specificity of the new screening studies were consistent with those of prior research. Brief interventions were confirmed to reduce alcohol use (Key Question 4a), although additional research is required for a wider array of health outcomes. One study highlighted the benefits of counseling interventions for newborn health indicators in pregnant women (Key Question 4b). No new evidence was found regarding the harms of screening (Key Question 3) or alcohol use reduction interventions (Key Question 5).

CONCLUSION

This review supports the continued use of brief interventions to reduce alcohol consumption in highrisk groups and highlights the need for culturally tailored research in Korea.

Assessment of the Prevalence of Alcoholic Beverage Consumption and Knowledge of the Impact of Alcohol on Health in a Group of Polish Young Adults Aged 18-35: A Cross-Sectional Study

Alcoholic beverages are widely consumed worldwide, especially by young adults. Their excessive consumption is associated with numerous health, social and financial damages. The level of knowledge of young adults about the health effects of consuming alcoholic beverages is low, and research in this area is conducted on small, unrepresentative groups. This cross-sectional study aimed to assess the prevalence of alcoholic beverage consumption and the level of knowledge about the impact of ethyl alcohol on health in a group of people aged 18−35. The survey results indicate that the majority of respondents regularly consume alcoholic beverages (94.6%), and they are at a low risk of excessive consumption (p < 0.0001). The most frequently chosen alcoholic beverage in the studied group was beer, and the least chosen one was vodka. The main motive for reaching for alcoholic beverages was the desire to improve mood. Respondents did not indicate significant changes in alcohol consumption during the COVID-19 pandemic, but participants in the high-risk group more often indicated an increase in alcohol consumption (p = 0.0025). The analysis of the level of knowledge showed that the participants in the study had an average or low level of knowledge about the effects of ethanol on health, with no significant relationships between the study groups. The obtained results indicate a strong need for the continuous education of young people on the effects of the excessive consumption of alcoholic beverages on the body, with particular emphasis on the consequences of using alcohol as a mood-enhancing agent.

Brief Underage Alcohol Use Screener Scores Predict Health Risk Behaviors

The aim of this study was to determine if adolescents' scores on a 2-item underage alcohol use screener predict risky consequences of past-year alcohol use and other health risk behaviors in a nonclinical, school-based sample of adolescents. A predominantly minority sample of 756 middle and high school students completed in-school tablet-based surveys on past-year underage alcohol use and a range of health risk behaviors. Higher scores for self alcohol risk and peer alcohol risk were associated with higher risk of past-year riding with a drunk driver and past 90-day measures of cigarette use, marijuana use, unplanned sex, and unprotected intercourse. The National Institute of Alcohol Abuse and Alcoholism Brief Alcohol Screener is a useful tool for school-based service providers, including school nurses, to identify and address the needs of adolescents at high risk of the development of alcohol use disorders, as well as a range of preventable health risk behaviors.

Factors Affecting Alcohol Abstinence Intentions of Inpatients With Alcohol Use Disorder

The current study investigated the effects of modifiable factors-alcohol abstinence self-efficacy, negative emotions, communication skills, and self-reflection-on alcohol abstinence intentions of 139 inpatients in South Korean psychiatric hospitals. Correlations between alcohol abstinence intentions and each factor were analyzed, and a hierarchical multiple regression was used to assess the relationship between alcohol abstinence intentions and general characteristics. Alcohol abstinence intentions were statistically significant among inpatients with a spouse (p = 0.018), higher education (p = 0.031), employment (p = 0.009), younger age (p < 0.001), and fewer admissions from alcohol use disorder (AUD) (p < 0.001). In addition, communication skills (p < 0.001) and self-reflection (p < 0.001) were predictors of alcohol abstinence intentions. Results confirm communication skills and self-reflection are modifiable factors that significantly contribute to increasing alcohol abstinence intentions among inpatients with AUD. Providing interventions that improve communication skills and self-reflection would help maintain alcohol abstinence and prevent relapse. [Journal of Psychosocial Nursing and Mental Health Services, 59(12), 23-32.].

Using the NIAAA Brief Alcohol Screener in Social Work Practice for Selected Prevention Targeting Youth

This article discusses the use of brief screeners in social work practice to identity adolescents in need of selected interventions for alcohol and other drug use problems. Brief screeners can increase access to alcohol or other drug intervention services and promote the diffusion of evidence-based interventions to underserved communities when integrated in Screening, Brief Intervention and Referral to Treatment (SBIRT) initiatives. The two-item NIAAA Brief Alcohol Use Screener is discussed as a developmentally-tailored assessment tool that can be integrated into SBIRT in social work practice to improve detection of early-stage alcohol problems among adolescents who lack routine access to preventative health care. The use of brief, empirically-supported alcohol screeners in trainings for social work students and new professionals can enhance their preparation and competence to offer child and adolescent clients appropriate selected intervention options to reduce harms associated with underage alcohol use.

Contrastive Analysis of Neuropsychology and Personality Characteristics of Male Lacunar Infarction Patients with Hazardous Drinking and Non-Hazardous Drinking

OBJECTIVE

To compare the differences in neuropsychological and personality characteristics between male patients with lacunar infarction with hazardous drinking and non-hazardous drinking.

METHODS

From May to October 2016, a total of 124 male outpatients and inpatients with lacunar infarction were selected in the Department of Neurology, Tongji Hospital, and they were divided into a hazardous drinking group (HD group, n=52) and a non-hazardous drinking group (NHD group, n=72) according to alcohol consumption habits. General information, MoCA score, EPQ score and SCL-90 score were compared between the two groups.

RESULTS

Incidence of cognitive disorder in the HD group and NHD group was 59.6% and 56.9% respectively, showing no significant difference (P>0.05). Scores of visuospatial and executive function, memory, attention and total MoCA score in the HD group were significantly lower than those in the NHD group (P<0.05), while no significant difference in naming, language, abstract thinking or orientation was found between the two groups (P>0.05). Scores of extroversion and introversion, neuroticism and psychoticism in the HD group were significantly higher than those in the NHD group (P<0.05), while no significant difference in lie or feint score was found between the two groups (P>0.05). Scores of somatization, interpersonal sensitivity, anxiety, hostility, bigotry and psychoticism factors, and total SCL-90 score in the HD group were significantly higher than those in the NHD group (P<0.05), while no significant difference in scores of obsessive-compulsive, depression and terror factors were found between the two groups (P>0.05).

CONCLUSION

Compared with male patients with lacunar infarction with non-hazardous drinking, male lacunar infarction patients with hazardous drinking showed worse visuospatial and executive function, memory, attentiveness, cognitive function and mental health status, with more obvious change of personality, thus extra attention is needed for male lacunar infarction patients with hazardous drinking.

Understanding Which Teenagers Benefit Most From a Brief Primary Care Substance Use Intervention

BACKGROUND AND OBJECTIVES

The primary care (PC) setting provides an opportunity to address adolescent alcohol and marijuana use. We examined moderators of effectiveness for a PC brief motivational intervention on adolescents' alcohol and marijuana use and consequences 1 year later.

METHODS

We conducted a randomized controlled trial in 4 PC clinics from April 2013 to November 2015 and followed adolescents using Web-based surveys. We examined whether demographic factors and severity of use moderated 12-month outcomes. Adolescents aged 12 through 18 were screened by using the National Institute on Alcohol Abuse and Alcoholism Screening Guide. Those identified as at risk were randomly assigned to the intervention (CHAT) or to usual care (UC).

RESULTS

The sample (n = 294) was 58% female, 66% Hispanic, 17% African American, 12% white, and 5% multiethnic or of other race with an average age of 16 years. After controlling for baseline values of outcomes, teens in CHAT who reported more negative consequences from drinking or had an alcohol use disorder at baseline reported less alcohol use, heavy drinking, and consequences 1 year later compared with teens in UC. Similarly, teens in CHAT with more negative consequences from marijuana use at baseline reported less marijuana use 1 year later compared with teens in UC; however, teens in CHAT who reported fewer marijuana consequences at baseline reported greater marijuana use 1 year later compared with teens in UC.

CONCLUSIONS

A brief intervention can be efficacious over the long-term for adolescents who report problems from alcohol and marijuana use. Findings emphasize the importance of both screening and intervention in at-risk adolescents in PC.

Identifying Problematic Substance Use in a National Sample of Adolescents Using Frequency Questions

BACKGROUND

Brief substance use screening questions for tobacco, alcohol, cannabis, and other drugs need further validation in adolescents. In particular, optimal age-specific screening cut-points are not known, and no study has been large enough to evaluate screening questions for noncannabis illicit drug use.

METHODS

Adolescent respondents to an annual national household survey were included (2008 to 2014; n = 169,986). Days of tobacco use in the past month, and days of alcohol, cannabis, other illicit drug use in the past year, were assessed as brief screens for tobacco dependence and DSM-IV alcohol (AUD), cannabis (CUD), and other illicit drug use disorders (DUD). Areas under receiver operating characteristics curves (AUCs), sensitivity and specificity were estimated separately by age group (12-15-, 16-17-, and 18-20-year-olds) and cut-points that maximized combined values of sensitivity and specificity were considered optimal.

RESULTS

The prevalence of tobacco dependence, AUD, CUD, and DUD was 5.8%, 7.1%, 4.5%, and 2.0%, respectively. AUCs ranged 0.84 to 0.99. The optimal cut-points for screening for tobacco dependence and DUDs was the same for all age groups: ≥1 day. The optimal cut-points for alcohol and cannabis varied by age: ≥3 days for 12-15-year-olds and ≥12 days for older adolescents.

CONCLUSIONS

Brief measures of past-year use, or past-month use for tobacco, accurately identified adolescents with problematic substance use. However, health systems should use age-specific screening cut-points for alcohol and cannabis to optimize screening performance.

Predictive Validity of a 2-Question Alcohol Screen at 1-, 2-, and 3-Year Follow-up

BACKGROUND

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) 2-question screen is a valid adolescent alcohol screening tool. No studies have examined if this tool predicts future alcohol problems. We conducted a study at 16 pediatric emergency departments to determine the tool's predictive validity for alcohol misuse and alcohol use disorders (AUDs).

METHODS

Participants (N = 4834) completed a baseline assessment battery. A subsample of participants completed the battery at 1, 2, and 3 years follow up.

RESULTS

Of the 2209 participants assigned to follow-up, 1611 (73%) completed a 1-year follow-up, 1591 (72%) completed a 2-year follow-up, and 1377 (62%) completed a 3-year follow-up. The differences in AUDs between baseline NIAAA screen nondrinkers and lower-risk drinkers were statistically significant at 1 year (P = .0002), 2 years (P <.0001), and 3 years (P = .0005), as were the differences between moderate- and highest-risk drinkers at 1 and 2 years (P < .0001 and P = .0088, respectively) but not at 3 years (P = .0758). The best combined score for sensitivity (86.2% at 1 year, 75.6% at 2 years, and 60.0% at 3 years) and specificity (78.1% at 1 year, 79.2% at 2 years, and 80.0% at 3 years) was achieved by using "lower risk" and higher as a cutoff for the prediction of a Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnosis.

CONCLUSIONS

The NIAAA 2-question screen can accurately characterize adolescent risk for future AUDs. Future studies are needed to determine optimaluse of the screen.