Screening for Adolescent Alcohol Use in the Emergency Department: What Does It Tell Us About Cannabis, Tobacco, and Other Drug Use?

Spirito, Anthony; Bromberg, Julie R; Casper, T. Charles; Chun, Thomas H.; Mello, Michael J.; Mull, Colette C.; Shenoi, Rohit; Vance, Cheryl; Ahmad, Fahd A.; Bajaj, Lalit; Brown, Kathleen M.; Chernick, Lauren S.; Cohen, Daniel M.; Fein, Joel A.; Horeczko, Timothy; Levas, Michael N.; McAninch, Brett; Monuteaux, Michael C.; Grupp-Phelan, Jackie; Powell, Elizabeth C.; Rogers, Alexander; Suffoletto, Brian; Linakis, James G.

doi:10.1080/10826084.2018.1558251

Cited by 5 publications

(7 citation statements)

References 40 publications

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“…Taken together with the sensitivity and specificity findings discussed below, any alcohol use in the past year increases the odds for meeting criteria for a CUD diagnosis one to three years later among adolescents receiving pediatric ED services. This investigation extends the cross-sectional finding that any drinking in the past year is associated with increased odds of a CUD at baseline 16 to one, two, and three-year follow-up time periods.…”

Section: Discussionsupporting

confidence: 73%

“…Cross-sectional data 16 also found that any selfreported alcohol use in the past year was significantly associated with a CUD and the association was stronger for high school students than middle school students. This association was also found across gender, ethnicity and race 16 . The purpose of the present study was to determine whether this common co-occurrence of alcohol and cannabis use in adolescence 17 held longitudinally such that alcohol use could predict future cannabis use.…”

Section: Introductionmentioning

confidence: 89%

“…An alcohol screening study, using the NIAAA two question screen (NIAAA 2QS 13 ), conducted in 16 US Pediatric Emergency Care Applied Research Network (PECARN) pediatric EDs found that 25% of adolescent PED patients reported past year alcohol use 14 and that the NIAAA 2QS identified both current AUD 13 and future AUD 15 . Cross-sectional data 16 also found that any self-reported alcohol use in the past year was significantly associated with a CUD and the association was stronger for high school students than middle school students. This association was also found across gender, ethnicity and race 16 .…”

Section: Introductionmentioning

confidence: 99%

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Adolescent Alcohol use Predicts Cannabis use over a three Year follow-up Period

et al. 2022

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Background: Alcohol and cannabis use frequently co-occur, which can result in problems from social and academic impairment to dependence (i.e., alcohol use disorder [AUD] and/or cannabis use disorder [CUD]). The Emergency Department (ED) is an excellent site to identify adolescents with alcohol misuse, conduct a brief intervention, and refer to treatment; however, given time constraints, alcohol use may be the only substance assessed due to its common role in unintentional injury. The current study, a secondary data analysis, assessed the relationship between adolescent alcohol and cannabis use by examining the National Institute of Alcohol Abuse and Alcoholism (NIAAA) two question screen's (2QS) ability to predict future CUD at one, two, and three years post-ED visit. Methods: At baseline, data was collected via tablet self-report surveys from medically and behaviorally stable adolescents 12-17 years old (n ¼ 1,689) treated in 16 pediatric EDs for non-life-threatening injury, illness, or mental health condition. Follow-up surveys were completed via telephone or web-based survey. Logistic regression compared CUD diagnosis odds at one, two, or three-year follow-up between levels constituting a single-level change in baseline risk categorization on the NIAAA 2QS (nondrinker versus low-risk, low-versus moderate-risk, moderate-versus high-risk). Receiver operating characteristic curve methods examined the predictive ability of the baseline NIAAA 2QS cut points for CUD at one, two, or three-year follow-up. Results: Adolescents with low alcohol risk had significantly higher rates of CUD versus nondrinkers (OR range: 1.94-2.76, p < .0001). For low and moderate alcohol risk, there was no difference in CUD rates (OR range: 1.00-1.08). CUD rates were higher in adolescents with high alcohol risk versus moderate risk (OR range: 2.39-4.81, p < .05). Conclusions: Even low levels of baseline alcohol use are associated with risk for a later CUD. The NIAAA 2QS is an appropriate assessment measure to gauge risk for future cannabis use.

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Section: Discussionsupporting

confidence: 73%

Section: Introductionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

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Adolescent Alcohol use Predicts Cannabis use over a three Year follow-up Period

et al. 2022

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“…Even though alcohol screening has been widely integrated into primary care and could provide insight into risk for other conditions in these settings, research on the association between alcohol use screening scores and other conditions is limited. 25,26 Although the 10-item Alcohol Use Disorders Identification Test (AUDIT) 27 is commonly used for alcohol use screening, the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C), an abbreviated 3-item version of the full AUDIT, also reliably identifies unhealthy alcohol use and alcohol use disorder. [28][29][30] Given the time constraints on primary care physicians, 31 brief screeners such as the AUDIT-C are useful and practical tools for unhealthy alcohol use screening.…”

Section: Introductionmentioning

confidence: 99%

Association of Alcohol Screening Scores With Adverse Mental Health Conditions and Substance Use Among US Adults

et al. 2020

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IMPORTANCE Alcohol screening may be associated with health outcomes that cluster with alcohol use (ie, alcohol-clustering conditions), including depression, anxiety, and use of tobacco, marijuana, and illicit drugs. OBJECTIVE To quantify the extent to which alcohol screening provides additional information regarding alcohol-clustering conditions and to compare 2 alcohol use screening tools commonly used for this purpose. DESIGN, SETTING, AND PARTICIPANTS This longitudinal cohort study used data from the Veterans Aging Cohort Study. Data were collected at 8 Veterans Health Administration facilities from 2003 through 2012. A total of 7510 participants were enrolled, completed a baseline survey, and were followed up. Veterans with HIV were matched with controls without HIV by age, race, sex, and site of care. Data were analyzed from January 2019 to December 2019. EXPOSURES The Alcohol Use Disorders Identification Test (AUDIT) and Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) were used to assess alcohol use, with 4 risk groups delineated for each test: score 0 to 7 (reference), score 8 to 15, score 16 to 19, and score 20 to 40 (maximum score) for the full AUDIT and score 0 to 3 (reference), score 4 to 5, score 6 to 7, and score 8 to 12 (maximum score) for the AUDIT-C. MAIN OUTCOMES AND MEASURES Alcohol-clustering conditions, including self-reported symptoms of depression and anxiety and use of tobacco, marijuana, cocaine, other stimulants, opioids, and injection drugs. RESULTS A total of 6431 US patients (6104 [95%] men; median age during survey years 2003-2004, 50 years [range, 28-86 years; interquartile range, 44-55 years]) receiving care in the Veterans Health Administration completed 1 or more follow-up surveys when the AUDIT was administered and were included in the present analyses. Of the male participants, 4271 (66%) were African American, 1498 (24%) were white, and 590 (9%) were Hispanic. The AUDIT and AUDIT-C scores were associated with each alcohol-clustering condition. In particular, an AUDIT score of 20 or higher

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“…In addition to recent reliability and validity analyses of the NIAAA brief screener, there is emerging evidence that scores from this alcohol screener predict cannabis use disorder diagnoses as well as lifetime use of tobacco or illicit drugs in clinical samples of adolescents (Spirito et al, 2019). What is not currently apparent, however, is the extent to which scores from the NIAAA Brief Alcohol Screener predict health risk behaviors in a school-based, nonclinical sample of adolescents.…”

Section: The Current Studymentioning

confidence: 99%

Brief Underage Alcohol Use Screener Scores Predict Health Risk Behaviors

Tubman

Meca

Schwartz

et al. 2019

The Journal of School Nursing

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

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Screening for Adolescent Alcohol Use in the Emergency Department: What Does It Tell Us About Cannabis, Tobacco, and Other Drug Use?

Cited by 5 publications

References 40 publications

Adolescent Alcohol use Predicts Cannabis use over a three Year follow-up Period

Adolescent Alcohol use Predicts Cannabis use over a three Year follow-up Period

Association of Alcohol Screening Scores With Adverse Mental Health Conditions and Substance Use Among US Adults

Brief Underage Alcohol Use Screener Scores Predict Health Risk Behaviors

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