A cascade of care for alcohol use disorder: Using 2015–2019 National Survey on Drug Use and Health data to identify gaps in past 12‐month care

2021 ◽  
Author(s):  
Carrie M. Mintz ◽  
Sarah M. Hartz ◽  
Sherri L. Fisher ◽  
Alex T. Ramsey ◽  
Elvin H. Geng ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Drug Use ◽  
National Survey ◽  
Alcohol Use Disorder ◽  
Health Data ◽  
Cascade Of Care

scholarly journals A Cascade of Care for Alcohol Use Disorder: Using 2015-2018 National Survey on Drug Use and Health Data to Identify Gaps in Care

2020 ◽  
Author(s):  
Carrie M. Mintz ◽  
Sarah M. Hartz ◽  
Sherri L. Fisher ◽  
Alex T. Ramsey ◽  
Elvin H. Geng ◽  
...  
Keyword(s):  
Health Care ◽  
Alcohol Use ◽  
Drug Use ◽  
Brief Intervention ◽  
Alcohol Use Disorder ◽  
Alcohol Misuse ◽  
Health Data ◽  
Health Care Settings ◽  
The Past ◽  
Cascade Of Care

ABSTRACTBackgroundAlthough effective treatments exist, alcohol use disorder (AUD) is undertreated. We used a cascade of care framework to understand gaps in care between diagnosis and treatment for persons with AUD.MethodsUsing 2015-2018 National Survey on Drug Use and Health data, we evaluated the following steps in the cascade of care: 1) prevalence of adults with AUD; 2) proportion of adults who utilized health care in the past 12 months; 3) were screened about alcohol use; 4) received a brief intervention about alcohol misuse; 5) received information about treatment for alcohol misuse; and 6) proportion of persons with AUD who received treatment. Analyses were stratified by AUD severity.ResultsOf the 171,766 persons included in the sample, weighted prevalence of AUD was 7.9% (95% CI 7.7-8.0%). Persons with AUD utilized health care settings at similar rates as those without AUD. Cascades of care showed the majority of individuals with AUD utilized health care and were screened about alcohol use, but the percent who received the subsequent steps of care decreased substantially. For those with severe AUD, 83.5% (CI: 78.3%-88.7%) utilized health care in the past 12 months, 73.5% (CI: 68.1%-78.9%) were screened for alcohol use, 22.7% (CI: 19.4%-26.0%) received a brief intervention, 12.4% (CI: 10%-14.7%) received information about treatment, and 20.5% (CI: 18%-23.1%) were treated for AUD. The greatest decrease in the care continuum occurred from screening to brief intervention and referral to treatment. More persons with severe AUD received treatment than were referred, indicating other pathways to treatment outside of the healthcare system.ConclusionsPersons with AUD utilize health care at high rates and are frequently screened about alcohol use, but few receive treatment. Health care settings-particularly primary care settings-represent a prime opportunity to implement pharmacologic treatment for AUD to improve outcomes in this high-risk population.

scholarly journals Co-Occurrence of Alcohol, Drug Use, DSM-5 Alcohol Use Disorder, and Symptoms of Drug Use Disorder on Both Sides of the U.S.-Mexico Border

2015 ◽  
Vol 39 (4) ◽  
pp. 679-687 ◽  
Author(s):  
Guilherme Borges ◽  
Sarah Zemore ◽  
Ricardo Orozco ◽  
Cheryl J. Cherpitel ◽  
Yu Ye ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Drug Use ◽  
Alcohol Use Disorder ◽  
Dsm 5 ◽  
Mexico Border ◽  
Drug Use Disorder ◽  
The U.S

scholarly journals Prevalence and correlates of non-daily and daily cannabis use among persons 15 years and older in South Africa: Results of a national survey in 2017

2020 ◽  
Author(s):  
Shandir Ramlagan ◽  
Karl Peltzer ◽  
Supa Pengpid
Keyword(s):  
Logistic Regression ◽  
Alcohol Use ◽  
Drug Use ◽  
Alcohol Use Disorder ◽  
Multinomial Logistic Regression ◽  
Health Indicators ◽  
Cannabis Use ◽  
Cross Sectional ◽  
Negatively Associated ◽  
Male Sex

Abstract BackgroundThe study aimed to assess the prevalence and correlates of non-daily and daily cannabis use among persons 15 years and older in South Africa.MethodIn a national cross-sectional 2017 survey, 39,207 persons 15 years and older (Median = 34 years) responded to a questionnaire on substance use and health variables. Multinominal logistic regression was used to assess the determinants of nondaily and daily cannabis use and logistic regression for the determinants of daily cannabis use among active cannabis users.ResultsResults indicate that 5.0% of the participants engaged in non-daily and 2.8% in daily cannabis use in the past 3 months. In adjusted multinomial logistic regression analysis, male sex, having Grade 8–11 education, Coloureds, alcohol use disorder, living with husband or wife, not living with a partner, and other drug use were positively and students were negatively associated with daily cannabis use. Male sex, younger age, living alone or single, living with a partner, alcohol use disorder, and other drug use were positively and multimorbidity was negatively associated with nondaily cannabis use. Compared to nondaily cannabis users, male sex had higher odds and students and other drug use had lower odds of daily cannabis use.ConclusionAbout one in ten participants engaged past 3-month cannabis use, and several sociodemographic and health indicators were identified associated with non-daily and daily cannabis use.

scholarly journals Open secret, or imagined problem: Drug and alcohol use in Tanzanian road traffic accident drivers

2020 ◽  
Author(s):  
Adeline Rose Dozois ◽  
Paulina Nkondora ◽  
Erin E Noste ◽  
Juma Mfinanga ◽  
Hendry R Sawe ◽  
...  
Keyword(s):  
Substance Use ◽  
High Risk ◽  
Alcohol Use ◽  
Drug Use ◽  
Alcohol Use Disorder ◽  
Screening Tool ◽  
Road Traffic ◽  
World Health ◽  
Urine Drug Screen ◽  
Research Assistants

Abstract Background Road traffic accidents (RTAs) have emerged as an important public health problem in low and middle-income countries, where 90% of RTA deaths occur. The World Health Organization has suggested strategies to address excess mortality from RTAs including efforts to combat driving while intoxicated. The association between substance use and RTAs is well known in high-income countries, but data is more limited in low-resource settings including Tanzania. The objective of this study is to examine the prevalence of drug use, alcohol use, and substance use disorders in Tanzanian RTA drivers. Methods This prospective observational study was conducted in the Emergency Department of Muhimbili National Hospital, a national referral hospital in Dar es Salaam, Tanzania. Research assistants available 24 hours per day enrolled adult drivers who presented within 24 hours of an RTA. In eligible patients, research assistants collected a saliva test of blood alcohol content (BAC) and a urine drug screen (UDS), and administered a validated substance abuse screening tool, the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), Patients were excluded from individual analyses if they could not produce a saliva or urine test or answer questions. Primary outcomes were rates of positive BAC, UDS and self-reported high-risk alcohol and drug use patterns. Descriptive statistics were calculated using Excel. Results We screened 5264 trauma patients and enrolled 538, in whom 191 had a BAC, 362 had a UDS, and 417 had a complete ASSIST. Fifteen of 191 patients (7.8%) had a positive BAC, and 68/362 (18.7%) patients had a UDS that was positive for at least one drug. Based on the ASSIST, 104/417 (24.5%) of patients were at moderate or high risk for alcohol use disorder. Few were at risk for disordered use of other non-tobacco substances. Conclusion In our population of drivers presenting within 24 hours of an RTA, positive BAC and UDS tests were rare. A substantial portion of the population was at moderate to high risk for an alcohol use disorder. Ideal screening for substance use in trauma populations may involve a verbal screening tool, particularly when the time between injury and hospital arrival is delayed.

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