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Kelpin SS, Moore TB, Hull LC, Dillon PM, Perry BL, Thacker LR, Hancock L, Svikis DS. Alcohol Use and Problems in Daily and Non-Daily Coffee Drinking College Females. JOURNAL OF SUBSTANCE USE 2018; 23:574-578. [PMID: 30853853 PMCID: PMC6405221 DOI: 10.1080/14659891.2018.1459901] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND For more than a decade, a large proportion of research on caffeine use in college students has focused on energy drinks (ED), demonstrating an association between ED consumption and heavy/problem alcohol use. The present study examined the relationship between daily coffee consumption and varied measures of alcohol use and problems in a sample of college women. METHODS Participants were undergraduate females (N=360) attending an urban university in 2001-02 and prior to the rise in ED popularity on college campuses. Analyses compared women who reported drinking coffee daily (DC; 16.9%), to women who did not (NDC; 83.1%) on standardized measures of alcohol use and problems. RESULTS For both past month and year of drinking, DC women generally reported consuming more alcohol and were 2.1-2.6 times more likely to screen at risk for alcohol problems than their NDC counterparts. DC women were also more likely than NDC women to report problems related to drinking (e.g., experiencing blackouts, inability to stop drinking after they had started). CONCLUSIONS Findings support potential benefits of health education and screening that goes beyond EDs, focusing on varied forms of caffeine consumption.
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Affiliation(s)
- Sydney S. Kelpin
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, United States
| | - Thomas B. Moore
- VA Boston Healthcare System, Brockton Campus, Brockton, MA, United States
| | - Lynn C. Hull
- Virginia Commonwealth University, Institute for Drug and Alcohol Studies, AWHARE (Addiction and Women’s Health: Advancing Research and Evaluation) Program, Richmond, VA, United States
| | - Pamela M. Dillon
- Center for Clinical and Translational Research, Virginia Commonwealth University, Richmond, VA, United States
| | | | - Leroy R. Thacker
- School of Nursing, Virginia Commonwealth University, Richmond, VA, United States
| | - Linda Hancock
- Wellness Resource Center, Virginia Commonwealth University, Richmond, VA, United States
| | - Dace S. Svikis
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, United States
- Institute for Women’s Health, Virginia Commonwealth University, Richmond, VA, United States
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Copeland LA, Blow FC, Barry KL. Health Care Utilization by Older Alcohol-Using Veterans: Effects of a Brief Intervention to Reduce At-Risk Drinking. HEALTH EDUCATION & BEHAVIOR 2016; 30:305-21. [DOI: 10.1177/1090198103030003006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The objective of the study was to estimate the effect of a brief alcohol-reduction intervention on health care use. Male veterans aged 55 years and older drinking more than guideline limits participated in an effective primary care-based randomized clinical trial to reduce drinking. Repeated measures ANCOVA assessed short-term and long-term changes in both inpatient and outpatient utilization. Stage of change (SOC) was assessed in a subsample to test for interaction between SOC and the intervention. Veterans exposed to the intervention used more outpatient medical services in the short term. Long-term effects on inpatient/outpatient use were not observed. SOC did not moderate the effect of the intervention but was associated with differential use of health care services. A cost-effective brief intervention to reduce drinking may spur increased efforts to seek health care. Early detection and management of alcohol-related or other illnesses might be expected to accrue savings in later years.
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Iorfino F, Alvares GA, Guastella AJ, Quintana DS. Cold Face Test-Induced Increases in Heart Rate Variability Are Abolished by Engagement in a Social Cognition Task. J PSYCHOPHYSIOL 2016. [DOI: 10.1027/0269-8803/a000152] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Abstract. The vagus nerve is a major constituent in the bidirectional relationship between the heart and the prefrontal cortex. This study investigated the role of the vagus in social cognition using the cold face test (facial cooling) to stimulate the vagus nerve and increase prefrontal inhibitory control. Heart Rate Variability (HRV) was measured to index parasympathetic outflow while social cognition ability was tested using the Reading the Mind in the Eyes Test (RMET). Healthy males (n = 25) completed the RMET under two conditions: with and without facial cooling. Results indicated that although facial cooling increased HRV at rest, there was no improvement in the RMET during the facial cooling condition. Interestingly, completing the RMET with facial cooling abolished this increase in HRV, suggesting interference along the vagal reflex arc. These results are consistent with the involvement of a common cortico-subcortical circuit in autonomic and cognitive processes, important for emotion recognition.
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Affiliation(s)
- Frank Iorfino
- Autism Clinic for Translational Research, Brain & Mind Research Institute, University of Sydney, Camperdown, NSW, Australia
| | - Gail A. Alvares
- Autism Clinic for Translational Research, Brain & Mind Research Institute, University of Sydney, Camperdown, NSW, Australia
| | - Adam J. Guastella
- Autism Clinic for Translational Research, Brain & Mind Research Institute, University of Sydney, Camperdown, NSW, Australia
| | - Daniel S. Quintana
- Autism Clinic for Translational Research, Brain & Mind Research Institute, University of Sydney, Camperdown, NSW, Australia
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Hulse GK, Saunders JB, Roydhouse RM, Stockwell TR, Basso MR. Screening for hazardous alcohol use and dependence in psychiatric in-patients using the AUDIT questionnaire. Drug Alcohol Rev 2009. [DOI: 10.1080/713659373] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Tait RJ, Hulse GK. A systematic review of the effectiveness of brief interventions with substance using adolescents by type of drug. Drug Alcohol Rev 2009; 22:337-46. [PMID: 15385228 DOI: 10.1080/0959523031000154481] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The aim of this paper is to evaluate the effectiveness of brief interventions (BI) with adolescents (mean age <20) in reducing alcohol, tobacco or other drug (ATOD) use by means of a systematic review of BI for adolescent substance use in the English language literature up to 2002. We identified 11 studies involving 3734 adolescents. Follow-up ranged from 6 weeks to 24 months. Motivational interviewing was the predominant approach, underpinning eight studies: the remaining three provided personalized health information. Seven papers reported outcomes for alcohol interventions and four involved other substances (including one with separate alcohol outcomes). The overall effect size was d=0.126 with borderline homogeneity (Q=14.9, df=9, p=0.09). The effect size from the eight alcohol interventions (n=1,075) was classified as significant but "small" (d=0.275). The remaining non-alcohol studies were considered separately as interventions involving tobacco or multiple substance use. The two interventions with tobacco involved a substantial sample (n=2,626) but had a very small effect (d=0.037), while the two interventions addressing multiple substances involved few participants (n=110) but had a medium-large effect (d=0.78). Across a diverse range of settings (dental clinic, schools, universities, substance treatment centres) and, therefore, probably diverse clients, BI conferred benefits to adolescent substance users. BI had a small effect on alcohol consumption and related measures. The data for tobacco interventions suggested a very small reduction, particularly with general community interventions. The effect of BI with multiple substances appears substantial but the small sample cautions against expansive generalization.
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Affiliation(s)
- Robert J Tait
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Nedlands, WA 6009, Australia.
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Scott E, Anderson P. Randomized controlled trial of general practitioner intervention in women with excessive alcohol consumption. Drug Alcohol Rev 2009; 10:313-21. [PMID: 16818295 DOI: 10.1080/09595239100185371] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Seventy two women drinking 21 units (210g) or more of alcohol per week were recruited from an opportunistic screening programme in eight English general practices. The women were randomized into control and treatment groups. Women in the treatment group received ten minutes advice from their general practitioner to reduce alcohol consumption. At one year follow-up, when analyzed by intention to treat, women in the treatment group had reduced their alcohol consumption from an average of 35-24 units per week. Similar reductions were found in the control group (from 37-27 units per week). The lack of evidence for a treatment effect may be explained by contamination of the control group by informal interventions.
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Affiliation(s)
- E Scott
- HEA Primary Health Care Unit, Block 10, The Churchill Hospital, Headington, Oxford, OX3 7LJ, UK
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8
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Correlates of Violence History Among Injured Patients in an Urban Emergency Department. J Addict Dis 2007; 26:61-75. [DOI: 10.1300/j069v26n03_07] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Chang G, Orav EJ, McNamara T, Tong MY, Antin JH. Depression, cigarette smoking, and hematopoietic stem cell transplantation outcome. Cancer 2004; 101:782-9. [PMID: 15305410 DOI: 10.1002/cncr.20431] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The relationships between psychological and behavioral variables and patient outcomes after hematopoietic stem cell transplantation (HSCT) are not known definitively but have great potential importance, since this lifesaving procedure is used increasingly to treat a variety of malignancies. The objective of this study was to evaluate psychosocial predictors of long-term survival and disease recurrence after patients underwent allogeneic HSCT for chronic myelogenous leukemia (CML). METHODS In this prospective cohort study, 114 adults were admitted for allogeneic HSCT to the Brigham and Women's Hospital between July, 1997 and January, 2002. The median follow-up was 882 days, and serial measures were taken for mood and substance use 6 months and 12 months posttransplantation. RESULTS With a 93% participation rate by all potentially eligible patients and with < 3% of patients loss to follow-up, univariate predictors of long-term survival and recurrence were identified. Cox proportional hazards regression models for survival and recurrence were developed. Depressive symptoms, as measured by the most recent Beck Depression Inventory (BDI), increased the risk of death by 7% for each point increase in the BDI score (P = 0.006). Fourteen of 17 patients who developed recurrent disease were cigarette smokers with an average of 22.3 pack-years. For each pack-year of cigarette smoking, the risk of recurrence increased by 1.7% (P = 0.01). CONCLUSIONS This study assessed the role of psychosocial variables prospectively among a clinically homogeneous but representative cohort of patients who underwent allogeneic HSCT. Although additional confirmatory studies are pending, it appears that depressive symptoms posttransplantation and cigarette smoking prior to transplantation affect outcomes adversely and may represent opportunities to improve the morbidity and mortality associated with HSCT for patients with CML.
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Affiliation(s)
- Grace Chang
- Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
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Ramos SDP, Woitowitz AB. Da cervejinha com os amigos à dependência de álcool: uma síntese do que sabemos sobre esse percurso. BRAZILIAN JOURNAL OF PSYCHIATRY 2004. [DOI: 10.1590/s1516-44462004000500006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Artigo de revisão sobre os estudos prospectivos a respeito da história natural do alcoolismo, com ênfase na contribuição de Vaillant, que discorre sobre o impacto de seus achados na evolução dos conceitos de uso nocivo e dependência, bem como suas principais implicações terapêuticas. É salientado o fato de as taxas de abstinência não terem aumentado no tratamento de dependentes graves nos últimos 25 anos.
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Saunders JB, Kypri K, Walters ST, Laforge RG, Larimer ME. Approaches to Brief Intervention for Hazardous Drinking in Young People. Alcohol Clin Exp Res 2004; 28:322-9. [PMID: 15112940 DOI: 10.1097/01.alc.0000113418.12889.08] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This article represents the proceedings of a symposium at the 2002 joint conference of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism in San Francisco. The chair was John B. Saunders. The focus of the symposium was on brief intervention approaches for hazardous drinking among young people. The presentations were (1) Evidence for the effectiveness of brief intervention as an approach to reducing hazardous alcohol use, by John B. Saunders; (2) College student hazardous drinking in New Zealand, the USA, UK, and Australia: implications for research, policy, and intervention, by Kypros Kypri; (3) Applications of motivational feedback on the college campus, by Scott T. Walters; (4) A population based individualized alcohol harm reduction feedback intervention: preliminary results from the college-based alcohol risk reduction (CBARR) trial, by Robert G. Laforge; and (5) Brief interventions: conclusions and future directions, by Mary E. Larimer.
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Affiliation(s)
- John B Saunders
- Centre for Drug and Alcohol Studies, School of Medicine, University of Queensland, Brisbane, Australia
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Zule WA, Flannery BA, Wechsberg WM, Lam WK. Alcohol use among out-of-treatment crack using African-American women. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2003; 28:525-44. [PMID: 12211364 DOI: 10.1081/ada-120006740] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE The purpose of this study was to categorize the quantity and frequency of alcohol use among African-American women who were abusing crack cocaine and to explore relationships between categories of alcohol use and demographic variables, cocaine use, comorbidity, and risky sexual behaviors. METHOD Data were collected from 635 out-of-treatment crack cocaine-abusing African-American women in the Raleigh/Durham area of North Carolina. The women were categorized as light (n = 272), moderate (n = 216), or heavy drinkers (n = 147). RESULTS Women classified as heavy drinkers were demographically similar to light and moderate drinkers. Heavy drinkers used more crack cocaine and were more likely to engage in sexual risk behaviors than were the other two drinking groups. The heavy drinkers also reported greater psychological distress, and they were more likely to report histories of physical, sexual, and emotional abuse. CONCLUSIONS Heavy alcohol use among crack-abusing African-American women may be a marker for a host of underlying problems that require special attention. The HIV prevention programs and substance abuse treatment programs that provide services to crack-abusing women should screen for heavy drinking. Women identified as heavy drinkers should undergo more in-depth assessments and receive additional referrals as appropriate.
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Affiliation(s)
- William A Zule
- Research Triangle Institute, Research Triangle Park, NC 27709-2194, USA.
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Petry NM, Martin B, Cooney JL, Kranzler HR. Give them prizes, and they will come: contingency management for treatment of alcohol dependence. J Consult Clin Psychol 2000; 68:250-7. [PMID: 10780125 DOI: 10.1037/0022-006x.68.2.250] [Citation(s) in RCA: 269] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study evaluated the efficacy of a contingency management (CM) procedure that provided opportunities to win prizes as reinforcers. At intake to outpatient treatment, 42 alcohol-dependent veterans were randomly assigned to receive standard treatment or standard treatment plus CM, in which they earned the chance to win prizes for submitting negative Breathalyzer samples and completing steps toward treatment goals. Eighty-four percent of the CM participants were retained in treatment for an 8-week period compared with 22% of the standard treatment participants (p < .001). By the end of the treatment period, 69% of those receiving CM were still abstinent, but 61% of those receiving standard treatment had used alcohol (p < .05). These results support the efficacy of this CM procedure. Participants earned an average of $200 in prizes. This CM procedure may be suitable for use in standard treatment settings because prizes can be solicited from the community.
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Affiliation(s)
- N M Petry
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington 06030-2103, USA.
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Saunders JB, Lee NK. Hazardous alcohol use: its delineation as a subthreshold disorder, and approaches to its diagnosis and management. Compr Psychiatry 2000; 41:95-103. [PMID: 10746911 DOI: 10.1016/s0010-440x(00)80015-2] [Citation(s) in RCA: 83] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
The last 20 years have seen a significant paradigm shift in how we view alcohol misuse. The dichotomous model of "alcoholism" and "normal drinking" has now been replaced by the concept of a spectrum of disorders. In this new framework, "hazardous alcohol use" is defined as a repeated pattern of drinking that confers the risk of harmful consequences. It is a typical example of a subthreshold disorder. Where actual physical or psychological harm or social problems have occurred, the terms "harmful alcohol use" and "alcohol abuse," respectively, are applied. These conditions would typically be considered to be above the clinical threshold. The most severe disorder, alcohol dependence, is a psychobiological syndrome with often severe physical, psychological, and social sequelae. This article describes how the concept of hazardous alcohol use originated, and reviews the intervention techniques that have been developed to induce and assist hazardous drinkers to reduce their consumption to nonhazardous levels. The findings from a series of World Health Organization (WHO) collaborative studies on brief interventions for hazardous alcohol use are described. This work has resulted in the development of the Alcohol Use Disorders Identification Test (AUDIT) screening instrument, which can detect over 90% of hazardous drinkers in a range of settings, and the demonstration that 5 minutes' structured advice can reduce hazardous consumption by 30%. The later phases of this program of work have examined strategies to promote the dissemination of brief interventions for hazardous alcohol use throughout primary health care, and the nationwide, systematic, and sustained utilization of these interventions.
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Affiliation(s)
- J B Saunders
- Centre for Drug and Alcohol Studies, Department of Psychiatry, University of Queensland, Royal Brisbane Hospital, Australia
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Campillo C, Romero M, Saldivar G, Ramos L. Problems associated with hazardous and harmful alcohol consumption in Mexico. RECENT DEVELOPMENTS IN ALCOHOLISM : AN OFFICIAL PUBLICATION OF THE AMERICAN MEDICAL SOCIETY ON ALCOHOLISM, THE RESEARCH SOCIETY ON ALCOHOLISM, AND THE NATIONAL COUNCIL ON ALCOHOLISM 1998; 14:397-413. [PMID: 9751956 DOI: 10.1007/0-306-47148-5_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
This chapter presents research findings from a collaborative project between Mexican investigators from the Mexican Institute of Psychiatry and the World Health Organization on the identification and treatment of harmful and hazardous drinking. A sample of 189 individuals who met criteria for hazardous drinking was selected for the study after screening 2319 outpatients attending clinics in two general hospitals in Mexico City. We present here the characteristics of this sample along dimensions that include alcohol related problems, history of trauma, alcohol dependence scores and family history of alcoholism. We rated, utilizing structures interviews, situations that place these individuals at risk of drinking. The possibility of constructing a typology of harmful and hazardous drinking was also explored. The significance of the findings of this investigation for health care clinicians is discussed.
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Affiliation(s)
- C Campillo
- Instituto Mexicano de Psiquiatría, Tlalpan, México
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Clements R. A critical evaluation of several alcohol screening instruments using the CIDI-SAM as a criterion measure. Alcohol Clin Exp Res 1998; 22:985-93. [PMID: 9726267 DOI: 10.1111/j.1530-0277.1998.tb03693.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Four alcohol screening instruments (the AUDIT, CAGE, MAST, and Svanum's scale) were administered to a sample of 306 undergraduate students at a Midwestern university and were compared with regard to several test characteristics, using the alcohol section of the CIDI-SAM (DSM-IV version) as the criterion measure. The performance of these instruments was evaluated using two subsets of subjects: (1) students who currently met diagnostic criteria for alcohol dependence (n = 35); and (2) students who met diagnostic criteria for alcohol dependence in the past and/or at present (i.e., lifetime diagnosis; n = 50). The AUDIT performed significantly better than the other three instruments in identifying students who were currently alcohol dependent, providing a moderate degree of clinical utility with this group. The four instruments did not differ significantly in their ability to identify students with a lifetime diagnosis; each measure provided only a modest degree of clinical utility with this group.
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Affiliation(s)
- R Clements
- Department of Psychology, Indiana University Northwest, Gary 46408-1197, USA
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Brown RL, Leonard T, Saunders LA, Papasouliotis O. The prevalence and detection of substance use disorders among inpatients ages 18 to 49: an opportunity for prevention. Prev Med 1998; 27:101-10. [PMID: 9465360 DOI: 10.1006/pmed.1997.0250] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Previous studies have found that substance use disorders are prevalent among inpatients of general medical hospitals. These studies were limited in the validity of their measures, their failure to distinguish between current and lifetime disorders, or their lack of attention to drugs other than alcohol. METHODS The current study used validate diagnostic instruments to measure current and lifetime alcohol and other drugs abuse and dependence among patients ages 18 through 49. Additionally, this study assessed the sensitivity and specificity of four substance abuse screening questions. Patients were recruited from the general medical, general surgery, and orthopedics services of a university hospital in Madison, Wisconsin. The sample included 363 patients, or 86.4% of those recruited. RESULTS The current and lifetime prevalence rates of substance use disorders were 21.8 and 49.6%, respectively. The prevalence rates of current problems were 16.3%, alcohol only; 2.5%, other drugs only; and 3.0%, alcohol and other drugs. Males had nearly a 30% current prevalence of current substance use disorders. The CAGE Questions Adapted to Include Drugs exhibited 70.9% sensitivity and 75.7% specificity. CONCLUSIONS At one hospital, and perhaps at others, an alcohol and drug screening, assessment, and intervention program may have the potential to prevent future health and social problems.
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Affiliation(s)
- R L Brown
- Department of Family Medicine, University of Wisconsin, Madison 53715, USA.
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Dunn CW, Donovan DM, Gentilello LM. Practical guidelines for performing alcohol interventions in trauma centers. THE JOURNAL OF TRAUMA 1997; 42:299-304. [PMID: 9042886 DOI: 10.1097/00005373-199702000-00021] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Nearly 50% of trauma patients are injured while under the influence of alcohol; however, addressing alcohol problems is not considered a routine component of trauma care. A public health approach to trauma prevention should include attention to underlying risk factors in the same way that advice regarding smoking cessation is offered in adult respiratory medicine clinics, and blood pressure, cholesterol, dietary, and exercise advice is provided in coronary care units. The Department of Health and Human Services, in its recent report to Congress, stated that efforts to reduce death and disability from injuries must be combined with efforts to reduce alcohol abuse, and called for an increase in the use of alcohol interventions in trauma patients. According to the National Academy of Sciences, the responsibility to provide counseling for patients with uncomplicated cases of mild to moderate alcohol abuse lies not with specialized alcohol treatment centers, but with physicians and other health care staff in general hospital settings trained to provide brief interventions. This paper provides practical guidelines for the administration of alcohol interventions that are suitable for trauma center use, and that have documented efficacy in reducing alcohol consumption.
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Affiliation(s)
- C W Dunn
- Department of Surgery, Harborview Medical Center, University of Washington School of Medicine, Seattle, USA
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Mar D, Johnson J, Pistorello J, Rigmaiden R, Veach TL. Prevalence of Substance Abuse and Smoking in a University Family Practice Setting. Subst Abus 1995. [DOI: 10.1080/08897079509444711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
Early intervention within a primary health-care setting for problems with ATOD use includes screening, assessment, and referral services, and cognitive and behavioral brief interventions. All health-care providers who care for adolescents should possess the basic skills to communicate effectively with young patients and with parents about their concerns about ATOD use problems, should be able to identify appropriate substance-abuse services in their communities, and should be able to determine the appropriate referral options for a given adolescent patients. Some difficulties will be encountered with the introduction of behavioral technologies into medical practice. As such, more research is needed to determine the most effective approach to incorporate brief interventions into the health-care setting. Health-care providers should incorporate the principles of effective patient-provider communication and the concepts of behavior-changing strategies into their daily practices.
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Affiliation(s)
- M J Werner
- Department of Pediatrics, Vanderbilt University, Nashville, Tennessee, USA
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Durfee MF, Warren DG, Sdao-Jarvie K. A model for answering the substance abuse educational needs of health professionals: the North Carolina Governor's Institute on Alcohol and Substance Abuse. Alcohol 1994; 11:483-7. [PMID: 7865148 DOI: 10.1016/0741-8329(94)90072-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Physicians can play an increased role in recognizing, intervening, and moderating their patients' misuse of alcohol and other drugs. This article explores the need for educational changes to permit physicians to develop skills in prevention, screening, and office-based treatment. It includes a personal account by one of the authors of his experience in recognizing deficiencies in substance abuse education both in his own medical school training and in today's health science curricula in the United States. It reviews prior initiatives by NIAAA/NIDA to address curriculum needs and describes an innovative collaborative model in North Carolina called the Governor's Institute on Alcohol and Substance Abuse. The Institute was created in 1990 as a nonprofit corporation to promote education, research, and communication among health professionals. Some of the Institute's programs are described, including its curriculum integration project in the state's four medical schools. The article concludes that the time is right to introduce substance abuse concepts into basic and continuing education for all health professionals.
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Affiliation(s)
- M F Durfee
- Governor's Institute on Alcohol and Substance Abuse, Inc., Research Triangle Park, NC 27709
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Kishchuk N, Peters C, Towers AM, Sylvestre M, Bourgault C, Richard L. Formative and effectiveness evaluation of a worksite program promoting healthy alcohol consumption. Am J Health Promot 1994; 8:353-62. [PMID: 10147193 DOI: 10.4278/0890-1171-8.5.353] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE This project involved the formative and effectiveness evaluation of a program aiming to enable working, nondependent drinkers to consume alcohol in a healthy and socially responsible fashion. DESIGN A baseline survey (n=387) of employee needs and interests was followed by a formative evaluation testing accessibility, interest/resistance, and potential effectiveness. The formative evaluation used successive iterations of focus groups. The subsequent effectiveness evaluation (n=268) used a randomized pre-post design with three conditions: alcohol program, placebo (nutrition) program, or no program. SETTINGS AND SUBJECTS The program was implemented in a multi-branch, blue-collar, shiftworking organization (n=813) in four Quebec cities with many mobile workers. INTERVENTION The worksite alcohol program consisted of two, half-hour sessions delivered one week apart by a health professional during paid time. The program provided information on the social and personal costs of alcohol, on strategies for promoting socially responsible drinking, and for the prevention of negative consequences of intoxication for oneself and one's family and friends. MEASURES Constructs measured using self-administered questionnaires were: alcohol knowledge, socially responsible attitudes, perceived self-efficacy for drinking management, and self-reported drinking behavior. RESULTS Despite the lack of interest in the topic (as found in the needs and interests survey), the program was effective in promoting socially responsible attitudes and reducing self-reported weekly consumption among participants. Some placebo effects were also present. Participants were not completely representative of all employees. CONCLUSION Worksite alcohol health promotion programs can be effective especially when promoting socially responsible attitudes.
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Affiliation(s)
- N Kishchuk
- Public Health Unit, Montreal General Hospital, Montreal, Quebec, Canada
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Anderson P, Scott E. The effect of general practitioners' advice to heavy drinking men. BRITISH JOURNAL OF ADDICTION 1992; 87:891-900. [PMID: 1525531 DOI: 10.1111/j.1360-0443.1992.tb01984.x] [Citation(s) in RCA: 144] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The objective of the study was to determine the effectiveness of advice from general practitioners to heavy drinking men (consuming 350-1050 grams of alcohol per week) to reduce their alcohol consumption. One hundred and fifty-four men recruited from eight general practices were allocated randomly to treatment and control groups. Men in the treatment group received advice from their own general practitioner. At one year follow-up, when analyzed according to intention to treat, the treatment group had reduced their consumption by an excess of 65 grams of alcohol per week when compared with the control group (p less than 0.05). General practitioners should be recommended to screen for alcohol consumption amongst their patients and to give advice to those found to be at risk because of their drinking.
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Affiliation(s)
- P Anderson
- Department of Public Health and Primary Care, Oxford University, UK
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Fleming MF, Barry KL, MacDonald R. The alcohol use disorders identification test (AUDIT) in a college sample. THE INTERNATIONAL JOURNAL OF THE ADDICTIONS 1991; 26:1173-85. [PMID: 1743817 DOI: 10.3109/10826089109062153] [Citation(s) in RCA: 271] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This study was conducted to estimate the psychometric properties of the questionnaire section of the Alcohol Use Disorders Identification Test (AUDIT) in a college sample using DSM-III criteria for alcohol abuse as the criterion standard. This alcohol screening test was developed for the 10 country AMETHYST project. In this young adult sample the instrument exhibited a sensitivity of .84 and specificity of .71 when utilizing the recommended cut-off score of 11. The 10-item questionnaire section of the AUDIT appears to have important advantages over other alcohol screening instruments such as the CAGE and the MAST.
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Affiliation(s)
- M F Fleming
- Department of Family Medicine, University of Wisconsin, Madison 53715
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Abstract
Three hundred and six adult medical and family practice inpatients at a university-affiliated teaching hospital were assessed for problem drinking using: (1) a short questionnaire containing the CAGE (a 4-question, self-report screening measure), and (2) a standardized review of medical records (an examination of specific blood chemistries and the physicians' and nurses' notes). Each patient completed one of two randomly assigned questionnaires containing the CAGE within the first 48 h of admission: a "Health Habits Questionnaire" or an "Alcohol Questionnaire." No significant differences were found between the two questionnaires with regard to the number of CAGE items endorsed. Overall, 16.9% of the subjects endorsed two or more CAGE items. Using the chart screening method, 11.4% of the total subjects were considered "probable" or "definite" problem drinkers. The screener's reading of the physicians' notes was the variable most important in determining overall chart screening assessment. The correlation between the two screening measures was relatively low (r = .38, p less than .001), suggesting that the two measures identify different populations of problem drinkers.
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Affiliation(s)
- B L Niles
- Rutgers, State University of New Jersey
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Kranzler HR, Babor TF, Lauerman RJ. Problems associated with average alcohol consumption and frequency of intoxication in a medical population. Alcohol Clin Exp Res 1990; 14:119-26. [PMID: 2178464 DOI: 10.1111/j.1530-0277.1990.tb00457.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The relationship between patterns of alcohol consumption and adverse consequences of drinking was examined in a cross-sectional study of hospital patients. Regular drinking that exceeds 40 g per day by males and 25 g per day by females was found to increase significantly the risk of a variety of alcohol-related medical and psychosocial problems. Similarly, frequent consumption of six or more drinks per occasion significantly increased the risk of problems for both men and women. Among males elevated average daily consumption contributed more to alcohol-related problems than frequency of intoxication, while the opposite was true for females. These results indicate that the frequency and amount of alcohol consumption are important risk factors for both nonalcoholics and alcoholics, and that measures of drinking pattern may be useful for screening purposes.
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Affiliation(s)
- H R Kranzler
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington 06032
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Abstract
In this article, a discussion of the definition and description of brief interventions is followed by broad reviews of their effectiveness in the cigarette smoking and alcohol fields. It is then argued that brief interventions should not be justified only in terms of early intervention; that there is at present insufficient evidence to warrant the abandonment of conventional outpatient treatment for clinic attenders; and that the relative contribution of motivational and active behaviour-change components of brief interventions is an important area for research.
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