1
|
Vetlugina TP, Prokopieva VD, Bokhan NA, Nikitina VB, Lobacheva OA, Mandel AI. Hormones, oxidized proteins, and lipids in alcoholism. Duration of remission. J Ethn Subst Abuse 2024; 23:569-585. [PMID: 37982405 DOI: 10.1080/15332640.2023.2280089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
The instability of remission in alcohol dependence (AD) creates a need to search for criteria for predicting its duration. The aim of study was to determine the hormones, oxidized proteins, and lipids in patients with AD, and the possible relations between these parameters and the duration of remission. Blood samples were obtained from 49 male patients with AD after alcohol detoxification (Total group). Two groups of patients were formed: with unstable therapeutic remission up to 6 months (UTR-group); with stable therapeutic remission which lasted 12 months or longer (STR-group). The control group comprised men without AD. The levels of carbonylated proteins (CP), lipid peroxidation (TBA-RS) were determined in the blood plasma. The levels of cortisol, testosterone total, thyroid-stimulating hormone (TSH), triiodothyronine free (fT3), and thyroxine free (fT4) in the blood serum were measured. The Total group of patients showed an increase in CP, TBA-RS, Cortisol, cortisol/testosterone ratio, and a decrease in TSH, fT3, and fT3/fT4 levels. A set of parameters (T, fT3, fT4, cortisol/testosterone ratio) associated with unstable remission was identified.
Collapse
Affiliation(s)
- Tamara P Vetlugina
- Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia
| | - Valentina D Prokopieva
- Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia
| | - Nikolay A Bokhan
- Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia
- Siberian State Medical University, Tomsk, Russia
- Tomsk State University, Tomsk, Russia
| | - Valentina B Nikitina
- Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia
| | - Olga A Lobacheva
- Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia
| | - Anna I Mandel
- Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia
| |
Collapse
|
2
|
Gamboa D, Kabashi S, Jørgenrud B, Lerdal A, Nordby G, Bogstrand ST. Is alcohol and psychoactive medication use associated with excess hospital length-of-stay and admission frequency? A cross-sectional, observational study. BMC Emerg Med 2024; 24:63. [PMID: 38627626 PMCID: PMC11020419 DOI: 10.1186/s12873-024-00979-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 03/28/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Hospital length-of-stay and admission frequency are commonly used indicators of disease burden and health resource expenditures. However, the impact of psychoactive prescription medication use and harmful alcohol consumption on both the duration and frequency of hospital admissions is under-explored. METHODS We conducted an analysis of data gathered from 2872 patients admitted to the Emergency Department at Lovisenberg Diaconal Hospital in Oslo, Norway. Psychoactive medicines (benzodiazepines, opioids, and z-hypnotics) were detected via liquid chromatography-mass spectrometry analysis of whole blood, while alcohol consumption was self-reported through the Alcohol Use Disorder Identification Test-4 (AUDIT-4). Using logistic regression, we examined associations with our primary outcomes, which were excess length-of-stay and admission frequency, defined as exceeding the sample median of 3.0 days and 0.2 admissions per year, respectively. RESULTS Compared to the absence of psychoactive medication, and after adjusting for age, gender, malignant disease, pre-existing substance use disorder and admission due to intoxication, the detection of two or more psychoactive medicines was associated with both excess length-of-stay (odds ratio [OR], 1.60; 95% confidence interval [CI], 1.20 to 2.14) and yearly hospitalization rate (OR, 3.72; 95% CI, 2.64 to 5.23). This association persisted when increasing the definition for excess length-of-stay to 4 and 5 days and to 1.0 and 1.5 admissions per year for admission frequency. Harmful alcohol consumption (AUDIT-4 scores of 9 to 16) was not associated with excess length-of-stay, but with excess admission frequency when defined as more than 1.0 admission per year when compared to scores of 4 to 6 (OR, 2.68; 95% CI, 1.58 to 4.57). CONCLUSIONS Psychoactive medication use is associated with both excess length-of-stay and increased antecedent admission frequency, while harmful alcohol consumption may be associated with the latter. The utility of our findings as a causal factor should be explored through intervention-based study designs.
Collapse
Affiliation(s)
- Danil Gamboa
- Department of Medicine, Lovisenberg Diaconal Hospital, Oslo, Norway.
- Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway.
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Saranda Kabashi
- Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Benedicte Jørgenrud
- Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Anners Lerdal
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Research Department, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Gudmund Nordby
- Department of Medicine, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Stig Tore Bogstrand
- Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
3
|
Jørgenrud BM, Bråthen CC, Steinson Stenehjem J, Kristiansen T, Rosseland LA, Bogstrand ST. Identifying excessive chronic alcohol use with phosphatidylethanol in patients with suspected severe injury-results from the IDART study. Alcohol Alcohol 2024; 59:agae014. [PMID: 38497164 PMCID: PMC10945293 DOI: 10.1093/alcalc/agae014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 02/02/2024] [Accepted: 02/16/2024] [Indexed: 03/19/2024] Open
Abstract
INTRODUCTION Acute and chronic alcohol use are well-known risk factors for accidents and injuries, and concurrent psychoactive drug use can increase injury risk further. Phosphatidylethanol (PEth) 16:0/18:1 is a biomarker used to determine alcohol consumption the previous 3-4 weeks. The aim was to investigate the prevalence of chronic alcohol use in trauma patients, as determined by PEth 16:0/18:1 concentrations, and how excessive chronic alcohol use relate to demographic variables, injury mechanisms and drug use. SETTING Patients received at Norwegian trauma hospitals from March 2019 to February 2020. The study is part of the Impairing Drugs and Alcohol as Risk factors for Traumatic Injuries study. METHODS All patients aged ≥ 16 years received with trauma team were included in the study. Data on injury date and mechanism, gender and age was registered. Blood samples were analyzed for 22 psychoactive medicinal and illicit drugs, ethanol and phosphatidylethanol 16:0/18:1. Regression analyses were conducted to assess associations between alcohol use and gender, age, injury mechanism and drug use. RESULTS AND CONCLUSION Of the 4845 patients included in the study, 10% had PEth 16:0/18:1 concentration ≥ 600 nM (~430 ng/mL), indicative of excessive chronic alcohol use. Being male, between 44-61 years old, involved in violence, and testing positive for medicinal drugs was associated with excessive chronic alcohol use.Excessive chronic alcohol use was common among males, middle-aged, patients with violence as injury mechanism and those with medicinal drug use. These findings emphasize the need to detect and treat excessive chronic alcohol use among trauma patients.
Collapse
Affiliation(s)
- Benedicte M Jørgenrud
- Section of Drug Abuse Research, Department of Forensic Science, Oslo University Hospital, P.O. Box 4950 Nydalen, N-0424 Oslo, Norway
| | - Camilla C Bråthen
- Division of Elverum-Hamar, Department of Acute Medicine, Innlandet Hospital Trust, P.O. Box 104, N-2381 Brumunddal, Norway
- Institute of Clinical Medicine, Department of Anesthesia and Intensive Care medicine, University of Oslo, P.O. Box 1171 Blindern, 0318 Oslo, Norway
| | - Jo Steinson Stenehjem
- Institute of Clinical Medicine, Department of Anesthesia and Intensive Care medicine, University of Oslo, P.O. Box 1171 Blindern, 0318 Oslo, Norway
| | - Thomas Kristiansen
- Institute of Clinical Medicine, Department of Anesthesia and Intensive Care medicine, University of Oslo, P.O. Box 1171 Blindern, 0318 Oslo, Norway
- Division of Emergencies and Critical Care, Department of Anaesthesiology, Oslo University Hospital, P.O. Box 4950, N-0424 Oslo, Norway
| | - Leiv Arne Rosseland
- Institute of Clinical Medicine, Department of Anesthesia and Intensive Care medicine, University of Oslo, P.O. Box 1171 Blindern, 0318 Oslo, Norway
- Division of Emergencies and Critical Care, Department of Research & Development, Oslo University Hospital, P.O. Box 4950, N-0424 Oslo, Norway
| | - Stig Tore Bogstrand
- Section of Drug Abuse Research, Department of Forensic Science, Oslo University Hospital, P.O. Box 4950 Nydalen, N-0424 Oslo, Norway
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Acute and Critical Illness, Oslo Metropolitan University, P.O. Box 4 St Olavs plass, N-0130 Oslo, Norway
- Department of Public Health Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, P.O. Box 1089 Blindern, 0318 Oslo, Norway
| |
Collapse
|
4
|
Hopstock LA, Kudryavtsev AV, Malyutina S, Cook S. Hazardous alcohol consumption and problem drinking in Norwegian and Russian women and men: The Tromsø Study 2015-2016 and the Know Your Heart study 2015-2018. Scand J Public Health 2023; 51:986-994. [PMID: 34965794 PMCID: PMC10599088 DOI: 10.1177/14034948211063656] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 11/11/2021] [Indexed: 11/16/2022]
Abstract
AIM Harmful use of alcohol is a worldwide public health concern. Cultural differences may affect responses to questions on alcohol problems, making international comparisons difficult. We aimed to compare self-reported alcohol consumption and problem drinking between Norwegian and Russian populations. METHODS We used data from women and men aged 40-69 years participating in the Tromsø Study seventh survey (Tromsø7, N=17646, participation 65%), Tromsø (2015-2016), Norway, and the Know Your Heart study (KYH, N=4099, participation 51%), Arkhangelsk and Novosibirsk (2015-2018), Russia. Alcohol consumption and problem drinking were measured by the Alcohol Use Disorders Identification Test (AUDIT) via questionnaires (Tromsø7) and interviews (KYH). We compared AUDIT scores and components between populations, by sex. RESULTS Non-drinking was more commonly reported in KYH compared with Tromsø7 (men 15.5% versus 4.9%, women 13.3% versus 7.3%). In men, hazardous consumption (41.4% versus 31.5%) and problem drinking (24.8% versus 19.6%) was higher in KYH compared with Tromsø7, but opposite for women (6.5% versus 12.0%, and 2.3% versus 5.8%). KYH men were less likely to report problem drinking behaviours than Tromsø7 men, with the exception of needing a drink first thing in the morning (13.2% versus 2.4%). KYH women consistently reported less consumption and problem drinking than Tromsø7 women. CONCLUSIONS We found between-study differences in hazardous drinking, but in men these were lower than suggested by differences in country-level statistics on alcohol consumption and alcohol-related health-harms. Study sample selection, stronger social desirability bias effects in the Russian samples, and cultural differences in responding could have affected the results.
Collapse
Affiliation(s)
| | - Alexander V. Kudryavtsev
- UiT The Arctic University of Norway, Norway
- Northern State Medical University, Russian Federation
| | - Sofia Malyutina
- Novosibirsk State Medical University, Russian Federation
- Institute of Internal and Preventive Medicine, Russian Federation
| | - Sarah Cook
- London School of Hygiene & Tropical Medicine, UK
- Imperial College London, UK
| |
Collapse
|
5
|
Cameron CM, Vuong K, McWhinney B, Zournazi A, Manzanero S, Warren J, Mitchell G, Vallmuur K, Howell T, Ungerer JPJ. Factors associated with higher alcohol concentrations in emergency department presentations: PACE study. Drug Alcohol Rev 2023; 42:1796-1806. [PMID: 37703216 DOI: 10.1111/dar.13744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 07/10/2023] [Accepted: 08/14/2023] [Indexed: 09/15/2023]
Abstract
INTRODUCTION The health impact from alcohol is of recognised concern, from acute intoxication as well as increased risk of chronic health issues over time. Identifying factors associated with higher alcohol consumption when presenting to the emergency department (ED) will inform public health policy and enable more targeted health care and appropriate referrals. METHODS Secondary testing of blood samples collected during routine clinical care of 1160 ED patients presenting to the Royal Brisbane and Women's Hospital in Queensland, Australia, for 10 days between 22 January and 1 February 2021. Alcohol was measured by blood ethanol (intake in recent hours) and phosphatidylethanol (PEth; intake over 2-4 weeks). Zero-inflated negative binomial regression was used to identify demographic and clinical factors associated with higher alcohol concentrations. RESULTS Males were found to have 83% higher blood ethanol and 32% higher PEth concentrations than females (adjusted rate ratio [ARR] 1.83, 95% confidence interval [CI] 1.37-2.45 and ARR 1.32, 95% CI 1.04-1.68, respectively). Blood ethanol concentrations were 3.4 times higher for those 18-44 years, compared to those aged 65+ (ARR 3.40, 95% CI 2.40-4.82) whereas PEth concentrations were found to be the highest in those aged 45-64 years, being 70% higher than those aged 65+ (ARR 1.70, 95% CI 1.19-2.44). Patients brought in involuntarily had eight-times higher blood ethanol concentrations than those who self-attended. DISCUSSION AND CONCLUSIONS This study used two alcohol markers to identify factors associated with higher alcohol concentrations in emergency presentations. The findings demonstrate how these biomarkers can provide informative data for public health responses and monitoring of alcohol use trends.
Collapse
Affiliation(s)
- Cate M Cameron
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Australia
| | - Kim Vuong
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Australia
| | - Brett McWhinney
- Chemical Pathology, Pathology Queensland, Queensland Health, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Anna Zournazi
- Chemical Pathology, Pathology Queensland, Queensland Health, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Silvia Manzanero
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia
| | - Jacelle Warren
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Australia
| | - Gary Mitchell
- Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia
- School of Medicine, University of Queensland, Brisbane, Australia
| | - Kirsten Vallmuur
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Australia
| | | | - Jacobus P J Ungerer
- Chemical Pathology, Pathology Queensland, Queensland Health, Royal Brisbane and Women's Hospital, Brisbane, Australia
- Faculty of Biomedical Science, University of Queensland, Brisbane, Australia
| |
Collapse
|
6
|
Stöth F, Kotzerke E, Thierauf-Emberger A, Weinmann W, Schuldis D. Can PEth be Detected with a Cutoff of 20 ng/mL after Single Alcohol Consumption? J Anal Toxicol 2023; 46:e232-e238. [PMID: 36107736 DOI: 10.1093/jat/bkac069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 08/15/2022] [Accepted: 09/13/2022] [Indexed: 01/26/2023] Open
Abstract
Phosphatidylethanol (PEth) can be determined in capillary blood collected as dried blood spots (DBS) and is a promising direct alcohol biomarker for the determination of drinking habits. Its use for abstinence monitoring needs to be evaluated. Studies with patients undergoing alcohol withdrawal have shown that the elimination of PEth can take up to 2 months. For the determination of PEth 16:0/18:1, a cutoff of 20 ng/mL has been agreed upon in the major US laboratories. However, it is not yet clear what minimum blood alcohol concentrations (BACs) have to be achieved by a single drinking episode to result in PEth concentrations above this cutoff after previous long-term abstinence. To determine whether low drinking amounts can result in a positive PEth concentration above 20 ng/mL, we recruited 12 participants ('social' drinkers). After 4 weeks of abstinence, alcohol was consumed at two separate drinking events with target BACs of 0.5 and 0.3 g/kg, resulting in maximum BACs in the ranges of 0.30-0.63 g/kg and 0.10-0.28 g/kg, respectively. Capillary blood was collected at different time points of the drinking experiment, and PEth was extracted from DBS and analyzed by liquid chromatography-tandem mass spectrometry. Despite drinking doses up to 0.58 g ethanol per kg body weight and reaching BACs of up to 0.63 g/kg, PEth 16:0/18:1 and PEth 16:0/18:2 could not be detected at or above the 20 ng/mL cutoff in any participant at any time after the drinking events. We conclude that after long-term abstinence the cutoff of 20 ng/mL for single alcohol consumption leading to BACs up to 0.63 g/kg is not exceeded.
Collapse
Affiliation(s)
- Frederike Stöth
- Institute of Forensic Medicine, Forensic Toxicology and Chemistry, University of Bern, Murtenstrasse 26, 3008 Bern, Switzerland
| | - Ephraim Kotzerke
- Institute of Forensic Medicine, Medical Center, University of Freiburg, Albertstraße 9, 79104 Freiburg, Germany
| | - Annette Thierauf-Emberger
- Institute of Forensic Medicine, Medical Center, University of Freiburg, Albertstraße 9, 79104 Freiburg, Germany
| | - Wolfgang Weinmann
- Institute of Forensic Medicine, Forensic Toxicology and Chemistry, University of Bern, Murtenstrasse 26, 3008 Bern, Switzerland
| | - Dominik Schuldis
- Institute of Forensic Medicine, Medical Center, University of Freiburg, Albertstraße 9, 79104 Freiburg, Germany
| |
Collapse
|
7
|
Determination of eight phosphatidylethanol homologues in blood by reversed phase liquid chromatography–tandem mass spectrometry – How to avoid co-elution of phosphatidylethanols and unwanted phospholipids. J Chromatogr A 2022; 1684:463566. [DOI: 10.1016/j.chroma.2022.463566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 11/23/2022]
|
8
|
Gomes HS, Farrington DP, Krohn MD, Cunha A, Jurdi J, Sousa B, Morgado D, Hoft J, Hartsell E, Kassem L, Maia Â. The impact of modes of administration on self-reports of offending: evidence from a methodological experiment with university students. JOURNAL OF EXPERIMENTAL CRIMINOLOGY 2022:1-21. [PMID: 36164649 PMCID: PMC9491655 DOI: 10.1007/s11292-022-09531-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/31/2022] [Indexed: 06/16/2023]
Abstract
Objectives Current knowledge about the causes of offending behavior is heavily reliant on self-reports of offending (SRO). However, methodological research on the impact of modes of administration on SRO is very scarce. Further, the existing evidence conflicts with the general knowledge about responding to sensitive questions. In this study, we aimed to test whether SRO are affected by modes of administration. Methods We carried out a methodological experiment, with a 2 (interviewer-administered vs. self-administered surveys) × 2 (paper-and-pencil vs. computer- assisted surveys) factorial design. A total of 181 undergraduate students were randomly assigned to one of these conditions and completed the International Self-Report Delinquency 3 (ISRD3) questionnaire. Results Findings showed an increased odds of reporting offending behavior in self-administered surveys, compared to face-to-face interviews. Paper-and-pencil and computer-assisted modes resulted in comparable estimates of offending. Conclusions This experiment provides evidence that SRO provide more accurate estimates of offending behavior using self-administered surveys.
Collapse
Affiliation(s)
- Hugo S. Gomes
- Psychology Research Centre (CIPsi/UM), University of Minho, Braga, Portugal
| | | | - Marvin D. Krohn
- Sociology and Criminology & Law, University of Florida, Gainesville, FL USA
| | - Ana Cunha
- Psychology Research Centre (CIPsi/UM), University of Minho, Braga, Portugal
| | - Julia Jurdi
- Psychology Research Centre (CIPsi/UM), University of Minho, Braga, Portugal
| | - Bárbara Sousa
- Psychology Research Centre (CIPsi/UM), University of Minho, Braga, Portugal
| | - Diogo Morgado
- Psychology Research Centre (CIPsi/UM), University of Minho, Braga, Portugal
| | | | | | - Leigh Kassem
- Sociology and Criminology & Law, University of Florida, Gainesville, FL USA
| | - Ângela Maia
- Psychology Research Centre (CIPsi/UM), University of Minho, Braga, Portugal
| |
Collapse
|
9
|
Finanger T, Vaaler AE, Spigset O, Aamo TO, Andreassen TN, Gråwe RW, Skråstad RB. Identification of unhealthy alcohol use by self-report and phosphatidylethanol (PEth) blood concentrations in an acute psychiatric department. BMC Psychiatry 2022; 22:286. [PMID: 35449039 PMCID: PMC9026645 DOI: 10.1186/s12888-022-03934-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 04/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The use of standard screening methods could improve the detection rate of unhealthy alcohol use in patients admitted to psychiatric acute and emergency departments. The aim of the present study was to investigate the ability of the alcohol biomarker phosphatidylethanol (PEth) to identify patients with high levels of alcohol consumption prior to admission. METHODS The data were prospectively collected at admittance to an acute psychiatric department in the period January 2016 to June 2017. A blood sample for the analysis of PEth was available from 177 patients. We compared the PEth concentrations with the Alcohol Use Disorders Identification Test (AUDIT) scores during the hospital stay, and psychiatric diagnoses at discharge. RESULTS A total of 45.8% of the patients had a PEth concentration ≥ 0.03 μmol/L, indicating significant alcohol consumption. AUDIT scores consistent with unhealthy alcohol use were present in 51.7%. There was a significant positive correlation between PEth concentrations and AUDIT scores (r = 0.631, p < 0.001). PEth was above the detection limit of 0.03 μmol/L in 19% of those reporting an average daily intake of zero alcohol units per day during the last week before admission. PEth concentrations were significantly higher among those with an alcohol diagnosis than among those without such a diagnosis (0.82 μmol/L vs. 0.09 μmol/L, p = 0.001). CONCLUSION PEth provides supplementary information on recent alcohol consumption in a psychiatric population and would be particularly helpful in patients unable or unwilling to give such information at admission.
Collapse
Affiliation(s)
- Trine Finanger
- Clinic of Substance Use and Addiction Medicine, St. Olav University Hospital, Klostergata 48, 7030, Trondheim, Norway. .,Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology - NTNU, Trondheim, Norway.
| | - Arne Einar Vaaler
- grid.52522.320000 0004 0627 3560Department of Acute Psychiatry, Division of Mental Health, St. Olav University Hospital, Trondheim, Norway ,grid.5947.f0000 0001 1516 2393Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology – NTNU, Trondheim, Norway
| | - Olav Spigset
- grid.5947.f0000 0001 1516 2393Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology – NTNU, Trondheim, Norway ,grid.52522.320000 0004 0627 3560Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway
| | - Trond Oskar Aamo
- grid.52522.320000 0004 0627 3560Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway
| | - Trine Naalsund Andreassen
- grid.52522.320000 0004 0627 3560Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway
| | - Rolf Wilhelm Gråwe
- grid.5947.f0000 0001 1516 2393Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology – NTNU, Trondheim, Norway ,grid.52522.320000 0004 0627 3560Department of Research and Development, Division of Mental Health, St. Olav University Hospital, Trondheim, Norway
| | - Ragnhild Bergene Skråstad
- grid.5947.f0000 0001 1516 2393Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology – NTNU, Trondheim, Norway ,grid.52522.320000 0004 0627 3560Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway
| |
Collapse
|
10
|
Kabashi S, Gamboa D, Vindenes V, Berg T, Hilberg TA, Jørgenrud B, Lerdal A, Bogstrand ST. Multimorbidity, psychoactive substance use and psychological distress among acute medically ill patients: a cross-sectional study. BMJ Open 2021; 11:e052428. [PMID: 34815283 PMCID: PMC8611427 DOI: 10.1136/bmjopen-2021-052428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND In order to target the complex health needs of patients with multimorbidity using psychoactive substances, knowledge regarding the association between substance use and multimorbidity in an acute setting is needed. AIMS Examine psychoactive substance use patterns among acute medically ill patients, and determine the association between multimorbidity and substance use, and psychological distress. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS 2874 acute medically ill patients admitted to a medical emergency department in Oslo, Norway. MEASUREMENTS Primary outcome: multimorbidity recorded by the presence of ≥2 International Classification of Diseases 10th revision-physical and/or mental health conditions per patient, extracted from medical records. Predictor variables: self-reported data on age, sex, occupational status, psychological distress (Hopkins Symptom Check List-5), alcohol use (Alcohol Use Disorder Identification Test-4) and results from blood samples on psychoactive medicinal and illicit drugs. FINDINGS Of all patients, 57.2% had multimorbidity. Of these, 62.6% reported psychological distress, 85.5% consumed either alcohol, medicinal and/or illicit drugs and 64.4% combined alcohol with psychoactive medicinal drugs. Patients with risky alcohol use were more likely to have multimorbidity compared with patients with low-risk alcohol use (OR 1.53; 95% CI 1.05 to 2.24). Patients using psychoactive medicinal drugs were more likely to have multimorbidity compared with non-users (OR 1.34; 95% CI 1.07 to 1.67). CONCLUSION Multimorbidity was associated with psychoactive medicinal drug and risky alcohol use, and psychological distress. Substance use was widespread, with alcohol and psychoactive medicinal drugs most frequently combined. Monitoring substance use among multimorbid patients is necessary to develop tailored treatments, and reduce burden on the healthcare system.
Collapse
Affiliation(s)
- Saranda Kabashi
- Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Danil Gamboa
- Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Vigdis Vindenes
- Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Thomas Berg
- Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
| | | | | | - Anners Lerdal
- Department of Interdiciplinary Health Sciencies, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Research, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Stig Tore Bogstrand
- Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
11
|
Smyth D, Wilson C, Searby A. Undergraduate nursing student knowledge and attitudes of healthcare consumers with problematic alcohol and other drug use: A scoping review. Int J Ment Health Nurs 2021; 30 Suppl 1:1293-1309. [PMID: 34363429 DOI: 10.1111/inm.12923] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 06/20/2021] [Accepted: 07/29/2021] [Indexed: 11/30/2022]
Abstract
Problematic alcohol and other drug use has a significant societal, personal, and financial burden. Nurses are key in responding to problematic alcohol and other drug use; however, research indicates many nurses hold negative attitudes towards people with substance and alcohol use disorders. Further, little content exists in most undergraduate degrees to address stigma held by new nurses. The objective of this scoping review, structured using Arksey and O'Malley's (International Journal of Social Research Methodology: Theory and Practice, 8 (1), 19-32, 2005) framework, is to examine studies that either explore or attempt to improve the knowledge and attitudes of undergraduate nurses caring for people who use alcohol and other drugs. Our initial search located 610 articles, and after screening, 14 articles were appraised using the Mixed Methods Appraisal Tool (MMAT) and included in this review. Most of the papers appraised were small, localized studies using evaluation methods considered low quality, but showed promising results in addressing stigma and confidence in providing care to people who use alcohol and other drugs. This review indicates that a consistent direction for improving knowledge and attitudes among undergraduate nursing students working with people who use alcohol and other drugs is urgently needed. Further studies of interventions, tested with more rigorous evaluation methodologies, are required to extend existing work in this area.
Collapse
Affiliation(s)
- Darren Smyth
- Alcohol and Other Drugs Service, Northern NSW Local Health District, Lismore, New South Wales, Australia
| | - Cate Wilson
- Alcohol and Other Drugs Service, Northern NSW Local Health District, Lismore, New South Wales, Australia
| | - Adam Searby
- Institute for Health Transformation, School of Nursing & Midwifery, Deakin University, Geelong, Victoria, Australia
| |
Collapse
|
12
|
Salagay OO, Soshkina KV, Brun EA, Kekelidze Z I, Klimenko T V, Kobyakova OS, Khalturina DA, Zykov V A. Scientifc assessment of the degree of implementation of the state policy to reduce abuse of alcoholic products and prevent alcoholism among the population of the Russian Federation until 2020. Public Health 2021. [DOI: 10.21045/2782-1676-2021-1-2-5-19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Goal. The goal of this study was to assess the scale of the implementation of the measures of the Concept to Reduce Alcohol Abuse Alcohol Dependence among the Population of the Russian Federation for the Period up to 2020.Methods. Research methods included legal analysis, as well as epidemiological and sociological data analysis.Results. The goals and the indicators of the Concept were achieved generally. According to our assessment, 15 (71%) out of 21 of the Concept’s measures have been implemented, among them 12 were fully, and 3 were partially (14%) implemented. Out of the 17 evidence-based measures of the Concept, 15 (88%) were implemented in full or in part.Alcohol consumption decreased from 15,7 to 9,1 liters of ethanol per capita (or by 42%) in 2008–2019. Mortality from accidental alcohol poisoning decreased by 60% (from 16,9 to 7 per 100.000) between 2008 and 2020. There was a signifcant decrease in the indicators of alcoholism in Russia during the period of the implementation of the Concept.Conclusions. The study shows that the goals, the objectives, the measures and the indicators of the Concept have been largely achieved. This was accompanied by the decrease in morbidity and mortality associated with alcohol consumption in Russia.
Collapse
Affiliation(s)
| | | | - E. A. Brun
- Moscow Research and PracticalCentre for Narcology of the Department of Public Health of Moscow
| | - Z. I. Kekelidze
- V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology
| | - T. V. Klimenko
- V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology
| | - O. S. Kobyakova
- Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation
| | - D. A. Khalturina
- Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation
| | - V. A. Zykov
- Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation
| |
Collapse
|
13
|
Neufeld M, Rehm J, Bunova A, Gil A, Gornyi B, Rovira, P, Manthey J, Yurasova E, Dolgova S, Idrisov B, Moskvicheva M, Nabiullina G, Shegaym O, Zhidkova I, Ziganshina Z, Ferreira-Borges C. Validation of a screening test for alcohol use, the Russian Federation. Bull World Health Organ 2021; 99:496-505. [PMID: 34248222 PMCID: PMC8243036 DOI: 10.2471/blt.20.273227] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 02/02/2021] [Accepted: 02/02/2021] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE To validate a Russian-language version of the World Health Organization's Alcohol Use Disorders Identification Test (AUDIT). METHODS We invited 2173 patients from 21 rural and urban primary health-care centres in nine Russian regions to participate in the study (143 declined and eight were excluded). In a standardized interview, patients who had consumed alcohol in the past 12 months provided information on their sociodemographic characteristics and completed the Russian AUDIT, the Kessler Psychological Distress Scale and the Composite International Diagnostic Interview to identify problem drinking and alcohol use disorders. We assessed the feasibility of administering the test, its internal consistency and its ability to predict hazardous drinking and alcohol use disorders in primary health care in the Russian Federation. FINDINGS Of the 2022 patients included in the study, 1497 were current drinkers with Russian AUDIT scores. The test was internally consistent with good psychometric properties (Cronbach's α : 0.842) and accurately predicted alcohol use disorders and other outcomes (area under the curve > 75%). A three-item short form of the test correlated well with the full instrument and had similar predictive power (area under the curve > 80%). We determined sex-specific thresholds for all outcomes, as non-specific thresholds resulted in few women being identified. CONCLUSION With the validated Russian AUDIT, there is no longer a barrier to introducing screening and brief interventions into primary health care in the Russian Federation to supplement successful alcohol control policies.
Collapse
Affiliation(s)
- Maria Neufeld
- World Health Organization European Office for Prevention and Control of Noncommunicable Diseases, Leontyevsky Pereulok 9, 125009 Moscow, Russian Federation
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
| | - Anna Bunova
- National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Artyom Gil
- Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Boris Gornyi
- National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Pol Rovira,
- Program on Substance Abuse, Public Health Agency of Catalonia, Barcelona, Spain
| | - Jakob Manthey
- Institute for Clinical Psychology and Psychotherapy, Technische Universität, Dresden, Germany
| | - Elena Yurasova
- World Health Organization Office in the Russian Federation, Moscow, Russian Federation
| | | | - Bulat Idrisov
- Moscow Institute of Physics and Technology, Moscow, Russian Federation
| | - Marina Moskvicheva
- Department of Public Health and Healthcare, South Ural State Medical University, Chelyabinsk, Russian Federation
| | | | - Olga Shegaym
- Center for Medical Prevention, Tomsk, Russian Federation
| | - Irina Zhidkova
- Amur Regional Center for Preventive Medicine, Blagoveshchensk, Russian Federation
| | - Zukhra Ziganshina
- Institute of Management, Economics and Finance, Kazan Federal University, Kazan, Russian Federation
| | - Carina Ferreira-Borges
- World Health Organization European Office for Prevention and Control of Noncommunicable Diseases, Leontyevsky Pereulok 9, 125009 Moscow, Russian Federation
| | - & the 2019/2020 RUS-AUDIT Collaborators & the RUS-AUDIT Project Advisory Board
- World Health Organization European Office for Prevention and Control of Noncommunicable Diseases, Leontyevsky Pereulok 9, 125009 Moscow, Russian Federation
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
- Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
- Program on Substance Abuse, Public Health Agency of Catalonia, Barcelona, Spain
- Institute for Clinical Psychology and Psychotherapy, Technische Universität, Dresden, Germany
- World Health Organization Office in the Russian Federation, Moscow, Russian Federation
- Vologda City Policlinic, Vologda, Russian Federation
- Moscow Institute of Physics and Technology, Moscow, Russian Federation
- Department of Public Health and Healthcare, South Ural State Medical University, Chelyabinsk, Russian Federation
- Center for Medical Prevention, Astrakhan, Russian Federation
- Center for Medical Prevention, Tomsk, Russian Federation
- Amur Regional Center for Preventive Medicine, Blagoveshchensk, Russian Federation
- Institute of Management, Economics and Finance, Kazan Federal University, Kazan, Russian Federation
| |
Collapse
|
14
|
Wilson T, Wisborg T, Vindenes V, Jamt RG, Furuhaugen H, Bogstrand ST. Psychoactive substances have major impact on injuries in rural arctic Norway - A prospective observational study. Acta Anaesthesiol Scand 2021; 65:824-833. [PMID: 33638866 DOI: 10.1111/aas.13807] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 02/09/2021] [Accepted: 02/13/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Rural areas have increased injury mortality with a high pre-hospital death rate. Knowledge concerning the impact of psychoactive substances on injury occurrence is lacking for rural arctic Norway. These substances are also known to increase pre-, per- and postoperative risk. The aim was by prospective observational design to investigate the prevalence and characteristics of psychoactive substance use among injured patients in Finnmark county. METHODS From January 2015 to August 2016, patients ≥18 years admitted to hospitals in Finnmark due to injury were approached when competent. Blood was analysed for ethanol, sedatives, opioids, hypnotics and illicit substances in consenting patients, who completed a questionnaire gathering demographic factors, self-reported use/behaviour and incident circumstances. RESULTS In 684 injured patients who consented to participation (81% consented), psychoactive substances were detected in 35.7%, alcohol being the most prevalent (23%). Patients in whom substances were detected were more often involved in violent incidents (odds ratio 8.92 95% confidence interval 3.24-24.61), indicated harmful use of alcohol (odds ratio 3.56, 95% confidence interval 2.34-5.43), reported the incident being a fall (odds ratio 2.21, 95% confidence interval 1.47-3.33) and presented with a reduced level of consciousness (odds ratio 3.91, 95% confidence interval 1.58-9.67). Subgroup analysis revealed significant associations between testing positive for a psychoactive substance and being diagnosed with a head injury or traumatic brain injury. CONCLUSION A significant proportion of injured patients had used psychoactive substances prior to admission. Use was associated with violence, falls, at-risk alcohol consumption, decreased level of consciousness on admittance and head injury.
Collapse
Affiliation(s)
- Thomas Wilson
- University of TromsøThe Arctic University of Norway Tromsø Norway
- Department of Forensic Sciences Section for Drug Abuse Research Oslo University Hospital Oslo Norway
- Department of Anaesthesia and Intensive Care Hammerfest HospitalFinnmark Hospital Trust Hammerfest Norway
| | - Torben Wisborg
- University of TromsøThe Arctic University of Norway Tromsø Norway
- Department of Anaesthesia and Intensive Care Hammerfest HospitalFinnmark Hospital Trust Hammerfest Norway
- Norwegian National Advisory Unit on Trauma Division of Emergencies and Critical Care Oslo University Hospital Oslo Norway
| | - Vigdis Vindenes
- Department of Forensic Sciences Section for Drug Abuse Research Oslo University Hospital Oslo Norway
| | - Ragnhild G. Jamt
- Department of Forensic Sciences Section for Drug Abuse Research Oslo University Hospital Oslo Norway
| | - Håvard Furuhaugen
- Department of Forensic Sciences Section for Drug Abuse Research Oslo University Hospital Oslo Norway
| | - Stig Tore Bogstrand
- Department of Forensic Sciences Section for Drug Abuse Research Oslo University Hospital Oslo Norway
- Institute of Health and Society Faculty of Medicine University of Oslo Oslo Norway
| |
Collapse
|
15
|
Jørgenrud B, Kabashi S, Nadezhdin A, Bryun E, Koshkina E, Tetenova E, Lerdal A, Norby G, Kolgashkin A, Petukhov A, Perekhodov S, Davydova E, Vindenes V, Gamboa D, Bogstrand ST. The Association between the Alcohol Biomarker Phosphatidylethanol (PEth) and Self-Reported Alcohol Consumption among Russian and Norwegian Medical Patients. Alcohol Alcohol 2021; 56:726-736. [PMID: 33677484 PMCID: PMC8557652 DOI: 10.1093/alcalc/agab013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 02/01/2021] [Accepted: 02/08/2021] [Indexed: 11/26/2022] Open
Abstract
Aims Valid measures to identify harmful alcohol use are important. Alcohol Use Disorders Identification Test (AUDIT) is a validated questionnaire used to self-report harmful drinking in several cultures and settings. Phosphatidylethanol 16:0/18:1 (PEth) is a direct alcohol biomarker measuring alcohol consumption levels. The aim of this study was to investigate how PEth levels correlate with AUDIT-QF and weekly grams of alcohol consumed among patients in two urban hospitals. In addition, we wanted to investigate the predictive value of PEth in identifying harmful alcohol use as defined by AUDIT-QF and weekly grams of alcohol cutoffs. Methods A cross-sectional study comprising acute medically ill patients with measurable PEth levels (≥0.030 μM) admitted to two urban hospitals in Oslo, Norway (N = 931) and Moscow, Russia (N = 953) was conducted using PEth concentrations in whole blood, sociodemographic data and AUDIT-QF questionnaires. Results PEth levels from patients with measurable PEth were found to be positively correlated with AUDIT-QF scores, with PEth cutpoints of 0.128 μM (Oslo) and 0.270 μM (Moscow) providing optimal discrimination for harmful alcohol use defined by AUDIT-QF (the difference between cities probably reflecting different national drinking patterns in QF). When converting AUDIT-QF into weekly grams of alcohol consumed, the predictive value of PEth improved, with optimal PEth cutpoints of 0.327 (Oslo) and 0.396 (Moscow) μM discriminating between harmful and non-harmful alcohol use as defined in grams (≥350 grams/week). Conclusions By using PEth levels and converting AUDIT-QF into weekly grams of alcohol it was possible to get an improved rapid and sensitive determination of harmful alcohol use among hospitalized patients.
Collapse
Affiliation(s)
- Benedicte Jørgenrud
- Department of Forensic Sciences, Oslo University Hospital, P.O. Box 4950 Nydalen, N-0424 Oslo, Norway
| | - Saranda Kabashi
- Department of Forensic Sciences, Oslo University Hospital, P.O. Box 4950 Nydalen, N-0424 Oslo, Norway.,Institute of Health and Society, Faculty of Medicine, University of Oslo, P.O. Box 1130 Blindern, N-0318 Oslo, Norway
| | - Aleksei Nadezhdin
- Moscow Research and Practical Centre on Addictions of Moscow, Department of Public Health, 109390, Ljublinskaya ul. 37/1, Moscow, Russia.,Russian Medical Academy of Continuous Professional Education, 125993, Barrikadnaya ul. 2/1, str. 1, Moscow, Russia
| | - Evgeny Bryun
- Moscow Research and Practical Centre on Addictions of Moscow, Department of Public Health, 109390, Ljublinskaya ul. 37/1, Moscow, Russia.,Russian Medical Academy of Continuous Professional Education, 125993, Barrikadnaya ul. 2/1, str. 1, Moscow, Russia
| | - Evgenya Koshkina
- Moscow Research and Practical Centre on Addictions of Moscow, Department of Public Health, 109390, Ljublinskaya ul. 37/1, Moscow, Russia
| | - Elena Tetenova
- Moscow Research and Practical Centre on Addictions of Moscow, Department of Public Health, 109390, Ljublinskaya ul. 37/1, Moscow, Russia
| | - Anners Lerdal
- Institute of Health and Society, Faculty of Medicine, University of Oslo, P.O. Box 1130 Blindern, N-0318 Oslo, Norway.,Research Department, Lovisenberg Diaconal Hospital, P.O. Box 04970, Nydalen N-0440 Oslo, Norway
| | - Gudmund Norby
- Medical Department, Lovisenberg Diaconal Hospital, P.O. Box 04970, Nydalen N-0440 Oslo, Norway
| | - Alexey Kolgashkin
- Moscow Research and Practical Centre on Addictions of Moscow, Department of Public Health, 109390, Ljublinskaya ul. 37/1, Moscow, Russia
| | - Alexei Petukhov
- Moscow Research and Practical Centre on Addictions of Moscow, Department of Public Health, 109390, Ljublinskaya ul. 37/1, Moscow, Russia.,Sechenov First Moscow State Medical University, 119991, Bolshaya Pirogovskaya ul. 2, str. 4, Moscow, Russia
| | - Sergey Perekhodov
- Demikhov Moscow Clinical Hospital, 109263, Shkuljova ul. 4, str. 1, Moscow, Russia
| | - Elena Davydova
- Demikhov Moscow Clinical Hospital, 109263, Shkuljova ul. 4, str. 1, Moscow, Russia
| | - Vigdis Vindenes
- Department of Forensic Sciences, Oslo University Hospital, P.O. Box 4950 Nydalen, N-0424 Oslo, Norway.,Norwegian Centre for Addiction Research, University of Oslo, P.O. Box 1130 Blindern, N-0318 Oslo, Norway
| | - Danil Gamboa
- Department of Forensic Sciences, Oslo University Hospital, P.O. Box 4950 Nydalen, N-0424 Oslo, Norway.,Institute of Health and Society, Faculty of Medicine, University of Oslo, P.O. Box 1130 Blindern, N-0318 Oslo, Norway.,Medical Department, Lovisenberg Diaconal Hospital, P.O. Box 04970, Nydalen N-0440 Oslo, Norway
| | - Stig Tore Bogstrand
- Department of Forensic Sciences, Oslo University Hospital, P.O. Box 4950 Nydalen, N-0424 Oslo, Norway.,Institute of Health and Society, Faculty of Medicine, University of Oslo, P.O. Box 1130 Blindern, N-0318 Oslo, Norway
| |
Collapse
|
16
|
Årving A, Høiseth G, Hilberg T, Trydal T, Husa A, Djordjevic A, Kabashi S, Vindenes V, Bogstrand ST. Comparison of the Diagnostic Value of Phosphatidylethanol and Carbohydrate‐Deficient Transferrin as Biomarkers of Alcohol Consumption. Alcohol Clin Exp Res 2020; 45:153-162. [DOI: 10.1111/acer.14503] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 10/26/2020] [Accepted: 10/29/2020] [Indexed: 12/17/2022]
Affiliation(s)
- Alexander Årving
- From the Department of Forensic Sciences (AÅ, GH, SK, VV, STB) Oslo University Hospital Oslo Norway
| | - Gudrun Høiseth
- From the Department of Forensic Sciences (AÅ, GH, SK, VV, STB) Oslo University Hospital Oslo Norway
- Faculty of Medicine (GH, SK, VV) Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Thor Hilberg
- Fürst Medisinsk Laboratorium (TH, TT, AH, AD) Oslo Norway
| | - Torleif Trydal
- Fürst Medisinsk Laboratorium (TH, TT, AH, AD) Oslo Norway
| | - Asgeir Husa
- Fürst Medisinsk Laboratorium (TH, TT, AH, AD) Oslo Norway
| | | | - Saranda Kabashi
- From the Department of Forensic Sciences (AÅ, GH, SK, VV, STB) Oslo University Hospital Oslo Norway
- Faculty of Medicine (GH, SK, VV) Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Vigdis Vindenes
- From the Department of Forensic Sciences (AÅ, GH, SK, VV, STB) Oslo University Hospital Oslo Norway
- Faculty of Medicine (GH, SK, VV) Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Stig Tore Bogstrand
- From the Department of Forensic Sciences (AÅ, GH, SK, VV, STB) Oslo University Hospital Oslo Norway
| |
Collapse
|
17
|
Jørgenrud B, Skadberg E, de Carvalho Ponce J, Furuhaugen H, Berg T. Determination of the alcohol biomarker phosphatidylethanol 16:0/18:1 and 33 compounds from eight different drug classes in whole blood by LC-MS/MS. J Pharmacol Toxicol Methods 2020; 107:106939. [PMID: 33257303 DOI: 10.1016/j.vascn.2020.106939] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 09/28/2020] [Accepted: 09/29/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Most bioanalytical LC-MS/MS methods are developed for determination of single drugs or classes of drugs, but a multi-compound LC-MS/MS method that can replace several methods could reduce both analysis time and costs. The aim of this study was to develop a high-throughput LC-MS/MS method for determination of the alcohol biomarker phosphatidylethanol 16:0/18:1 (PEth 16:0/18:1) and 33 other compounds from eight different drug classes in whole blood. METHODS Whole-blood samples were prepared by 96-well supported liquid extraction (SLE). Chromatographic separations were performed on a biphenyl core shell column with a mobile phase consisting of 10 mM ammonium formate, pH 3.1 and methanol. Each extract was analyzed twice by LC-MS/MS, injecting 0.4 μL and 2 μL, in order to obtain narrow and symmetrical peaks and good sensitivity for all compounds. Stable isotope-labeled internal standards were used for 31 of the 34 compounds. RESULTS A 96-well SLE reversed phase LC-MS/MS method for determination of PEth 16:0/18:1 and 33 other compounds from eight different drug classes was developed and validated. By using an organic solvent mixture of isopropanol/ methyl tert-butyl ether (1:5, v:v), all compounds, including the polar and ampholytic compounds pregabalin, gabapentin and benzoylecgonine, was extracted by 96-well SLE. DISCUSSION/CONCLUSION For the first time an LC-MS/MS method for the determination of alcohol biomarker PEth 16:0/18:1 and drugs and metabolites from several different drug classes was developed and validated. The developed LC-MS/MS method can be used for high-throughput analyses and sensitive determinations of the 34 compounds in whole blood.
Collapse
Affiliation(s)
- Benedicte Jørgenrud
- Section of Drug Abuse Research, Department of Forensic Sciences, Division of Laboratory Medicine, Oslo University Hospital, P.O. Box 4950 Nydalen, N-0424 Oslo, Norway
| | - Eline Skadberg
- Section of Drug Abuse Research, Department of Forensic Sciences, Division of Laboratory Medicine, Oslo University Hospital, P.O. Box 4950 Nydalen, N-0424 Oslo, Norway
| | - Julio de Carvalho Ponce
- Department of Preventive Medicine, School of Medicine, University of Sao Paulo, Av Dr. Arnaldo, 455, Brazil
| | - Håvard Furuhaugen
- Section of Drug Abuse Research, Department of Forensic Sciences, Division of Laboratory Medicine, Oslo University Hospital, P.O. Box 4950 Nydalen, N-0424 Oslo, Norway
| | - Thomas Berg
- Section of Drug Abuse Research, Department of Forensic Sciences, Division of Laboratory Medicine, Oslo University Hospital, P.O. Box 4950 Nydalen, N-0424 Oslo, Norway.
| |
Collapse
|
18
|
Gerbase FE, Tegner M, Krutzmann ME, Muller VV, Alff JDA, da Silva VB, Sagrilo OP, Linden R, Antunes MV. Blood phosphatidyl ethanol levels as a tool to detect alcohol misuse in trauma patients. Clin Toxicol (Phila) 2020; 59:418-425. [PMID: 33021410 DOI: 10.1080/15563650.2020.1822531] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION There is a strong need for a reliable marker of harmful alcohol consumption to identify injured patients that can benefit from alcohol interventions, and blood phosphatidyl ethanol (PEth) has not previously been tested on this population. This study aims to compare the performance of blood PEth concentration, blood alcohol concentration (BAC) and the Alcohol Use Disorders Identification Test Consumption (AUDIT-C) for the screening of alcohol misuse in trauma patients. METHODS Prospective cross-sectional study of 238 adult patients presenting in the emergency department with any type of trauma. PEth concentration was determined in whole blood by high-performance liquid chromatography with tandem mass spectrometry. Consent, AUDIT-C score and demographic data were obtained. RESULTS The sample consisted of majority male (67.6%), single (46.2%) and employed (66%) patients. The most common type of trauma was traffic collision (63.9%). The mean age was 41.7 years. We found a significant correlation between PEth levels with AUDIT-C score (Spearman's r = 0.654; p < .0001). PEth had an area under the ROC curve of 0.885 to detect hazardous alcohol consumption (AUDIT-C score ≥ 6) and PEth ≥23.9 ng/mL cutoff point provided 91.2% of sensitivity and 78.4% of specificity. Twelve patients reported alcohol abstinence, but had quantifiable levels of PEth. CONCLUSIONS PEth levels and AUDIT-C score had a moderate correlation in our population. PEth was useful to identify 12 cases of underreporting of alcohol consumption habits. PEth shows promising results, but more research is needed to identify the best screening tool for alcohol misuse in trauma patients.
Collapse
Affiliation(s)
- Fernando Engel Gerbase
- Postgraduate Program on Toxicology and Analytical Toxicology, Universidade Feevale, Novo Hamburgo, Brazil.,Laboratory of Analytical Toxicology, Institute of Health Sciences, Universidade Feevale, Novo Hamburgo, Brazil.,Emergency Department, Novo Hamburgo Municipal Hospital, Novo Hamburgo, Brazil
| | - Mariane Tegner
- Laboratory of Analytical Toxicology, Institute of Health Sciences, Universidade Feevale, Novo Hamburgo, Brazil
| | - Maria Eduarda Krutzmann
- Laboratory of Analytical Toxicology, Institute of Health Sciences, Universidade Feevale, Novo Hamburgo, Brazil
| | - Victória Vendramini Muller
- Laboratory of Analytical Toxicology, Institute of Health Sciences, Universidade Feevale, Novo Hamburgo, Brazil
| | - Jonatan de Andrade Alff
- Laboratory of Analytical Toxicology, Institute of Health Sciences, Universidade Feevale, Novo Hamburgo, Brazil
| | - Vanessa Becher da Silva
- Laboratory of Analytical Toxicology, Institute of Health Sciences, Universidade Feevale, Novo Hamburgo, Brazil
| | | | - Rafael Linden
- Postgraduate Program on Toxicology and Analytical Toxicology, Universidade Feevale, Novo Hamburgo, Brazil.,Laboratory of Analytical Toxicology, Institute of Health Sciences, Universidade Feevale, Novo Hamburgo, Brazil
| | - Marina Venzon Antunes
- Postgraduate Program on Toxicology and Analytical Toxicology, Universidade Feevale, Novo Hamburgo, Brazil.,Laboratory of Analytical Toxicology, Institute of Health Sciences, Universidade Feevale, Novo Hamburgo, Brazil
| |
Collapse
|
19
|
Gamboa D, Jørgenrud B, Bryun EA, Vindenes V, Koshkina EA, Nadezhdin AV, Kabashi S, Tetenova EJ, Berg T, Nyman AAT, Kolgashkin AJ, Petukhov AE, Perekhodov SN, Davydova EN, Lerdal A, Nordby G, Bogstrand ST. Prevalence of psychoactive substance use among acutely hospitalised patients in Oslo and Moscow: a cross-sectional, observational study. BMJ Open 2020; 10:e032572. [PMID: 32948540 PMCID: PMC7500296 DOI: 10.1136/bmjopen-2019-032572] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES The use of psychoactive prescription medication is increasing in the general population. This is a cause for concern, particularly among the elderly, where physiological changes related to senescence increase the risk for adverse effects. While previous studies regarding psychoactive substance use have generally been population based, we sought to determine the frequency of such use among acutely hospitalised patients. SETTING Two emergency departments (EDs), one in Oslo and one in Moscow, admitting patients to Departments of Internal Medicine. PARTICIPANTS 5583 patients aged ≥18 years participated, distributed evenly between genders and study locations. Patients unable to give informed consent were excluded. The study sites did not admit patients with surgical conditions and/or injuries. PRIMARY AND SECONDARY OUTCOMES The presence of psychoactive substances was determined through blood analysis using liquid chromatography-mass spectrometry. Secondary outcomes comprised demographic data (including age, gender, employment and marital status), degree of psychological distress, concurrent alcohol use, and self-reported alcohol, psychoactive drug and illicit substance use. RESULTS 32.3% in Oslo and 12% in Moscow were positive for one or more psychoactive medicinal drugs (benzodiazepines, z-hypnotics, opioids or barbiturates). In Oslo, medicinal drug use was associated with being aged 61 to 70 years (OR 2.40, 95% CI 1.61 to 3.58) compared with 18 to 40 years, and psychological distress (OR 2.61, 95% CI 2.06 to 3.30). In Moscow, psychoactive medicinal drug use was also associated with psychological distress (OR 1.68, 95% CI 1.18 to 2.39), and was less common among patients aged 41 to 60 years (OR 0.62, 95% CI 0.43 to 0.88) than among patients aged 18 to 40 years. CONCLUSION A significant proportion of admitted patients used one or more psychoactive medicinal drugs, in particular benzodiazepines (Oslo and Moscow) and opiates (Oslo). We suggest formalised screening for inappropriate prescription drug use and increased adherence to clinical prescription guidelines.
Collapse
Affiliation(s)
- Danil Gamboa
- Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
- Department of Internal Medicine, Lovisenberg Diaconal Hospital, Oslo, Norway
| | | | - Evgeny A Bryun
- Moscow Research and Practical Centre on Addictions, Moscow Department of Health, Moscow, Russia
- Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - Vigdis Vindenes
- Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
| | - Evgenya A Koshkina
- Moscow Research and Practical Centre on Addictions, Moscow Department of Health, Moscow, Russia
| | - Aleksei V Nadezhdin
- Moscow Research and Practical Centre on Addictions, Moscow Department of Health, Moscow, Russia
- Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - Saranda Kabashi
- Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Elena J Tetenova
- Moscow Research and Practical Centre on Addictions, Moscow Department of Health, Moscow, Russia
| | - Thomas Berg
- Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
| | | | - Alexey J Kolgashkin
- Moscow Research and Practical Centre on Addictions, Moscow Department of Health, Moscow, Russia
| | - Aleksei E Petukhov
- Moscow Research and Practical Centre on Addictions, Moscow Department of Health, Moscow, Russia
- Sechenov First Moscow State Medical University, Moscow, Russia
| | | | | | - Anners Lerdal
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Research, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Gudmund Nordby
- Department of Internal Medicine, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Stig Tore Bogstrand
- Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
20
|
Lundervold AJ, Jensen DA, Haavik J. Insomnia, Alcohol Consumption and ADHD Symptoms in Adults. Front Psychol 2020; 11:1150. [PMID: 32536897 PMCID: PMC7269111 DOI: 10.3389/fpsyg.2020.01150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 05/05/2020] [Indexed: 12/03/2022] Open
Abstract
Introduction Substance use disorders and insomnia are common in the general population, and particularly among adults with attention-deficit/hyperactivity disorder (ADHD). Here we investigated the relationship between insomnia, alcohol consumption and ADHD symptoms. Methods Adults with an ADHD diagnosis (n = 235, 41.3% males) and controls (n = 184, 38% males) completed a questionnaire assessing insomnia (Bergen Insomnia Scale), alcohol consumption (Alcohol Use Disorders Identification Test), and current ADHD symptoms (Adult ADHD Self-report Scale). The majority of the sample (95%) gave additional information about childhood ADHD symptoms (Wender Utah Rating Scale), and information about lifetime occurrence of an internalizing disorder was included as part of background information. Results Compared to controls, the ADHD group reported a higher frequency of insomnia, a higher quantity of consumed alcohol and a higher frequency of internalizing disorders. Current and childhood ADHD symptoms were more severe in those with than without insomnia. Scores on ADHD symptom scales were explained by the presence of insomnia and internalizing disorders, while the contribution from alcohol consumption was restricted to the control group. Discussion The high functional impact of insomnia, alcohol misuse and internalizing disorders is well known. The present study contributed by focusing on their relations to ADHD symptoms, and by showing that strong relations were not restricted to adults with a clinical ADHD diagnosis. By this, the results put a critical light on a categorical delineation between adults with an ADHD diagnosis and population selected controls, and call for further studies including dimensional metrics of ADHD symptoms and co-occurring problems.
Collapse
Affiliation(s)
- Astri J Lundervold
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Daniel A Jensen
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Jan Haavik
- Department of Biomedicine, University of Bergen, Bergen, Norway.,Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| |
Collapse
|
21
|
Daily use of alcohol in the Norwegian general population: Prevalence and associated factors. DRUGS AND ALCOHOL TODAY 2020. [DOI: 10.1108/dat-02-2020-0010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Purpose
Harmful use of alcohol is a major public health problem. While harm is often researched in the context of heavy drinking episodes, high-frequency drinking, even when drinking moderate quantities, constitutes a health risk in a longer perspective. The purpose of this paper is to examine the prevalence of daily use of alcohol in the Norwegian general population and to assess sociodemographic, mental health-related and personal resource variables associated with daily use of alcohol.
Design/methodology/approach
A cross-sectional survey concerned with health, illness and serious life events was distributed to 5,500 persons in the general population in Norway (response rate 36%). Sociodemographic variables, personal resource variables (general self-efficacy, optimism and extraversion) and psychological distress (current anxiety and/or depression) were assessed with regards to their associations with daily drinking in unadjusted and adjusted regression models.
Findings
Daily use of alcohol was reported by 39 persons (2.2%) in the sample (3.1% of men and 1.4% of women). While general self-efficacy, optimism and extraversion were unrelated to daily drinking, the adjusted model revealed that male sex (OR: 2.18, p < 0.05), being unemployed/not in education (OR: 3.10, p < 0.05) and reporting current anxiety and/or depression (OR: 3.12, p < 0.01) were associated with daily use of alcohol.
Originality/value
The study has contributed to the knowledge about daily drinkers in a representative sample of the Norwegian population. A proportion of 2.2% was found to drink alcohol on a daily basis. Compared to their counterparts, the odds of daily drinking were higher for men, unemployed persons and persons reporting current psychological distress. Public health initiatives aiming at reducing harmful use of alcohol may pay particular attention to these subsets of the population.
Collapse
|