Substance use disorder risk assessment: Preventing use disorder

Title : Substance use disorder risk assessment: Preventing use disorder

Abstract:

Introduction:  There were over one-million drug overdoses in the US during the period of the largely iatrogenic opioid epidemic¹ with over one-hundred thousand in one-year.² Unfortunately, current screening tools for AUD or SUD are designed to discover these diseases at a late stage.  Prevention is the best method to avoid AUD or SUD.  To date, there is no research describing an instrument such as this investigation proposes. The goal of this study was to develop a simple prevention tool for patients who may be prone to develop AUD and/or SUD prior to the development of addiction.

Methods: Participants (N = 259) were recruited from an urgent care clinic and received either acute care or medical treatment for SUD.  Patients receiving acute care were assigned to the comparison group (N = 126, 50.8% female, 5.7% non-white, 27.2% age < 34) and those receiving treatment for SUD were assigned to the Medical Assisted Treatment (MAT) group (N =133, 40.8% female, 4.8% non-white, 36.8% age < 34).  Surveys included questions about demographics (4 items), risk factors for AUD/SUD (6 items), information about their first alcohol and opioid experiences (16 items), and factors for seeking AUD/SUD treatment and recovery (2 items).  There were items about first-time usage and participants were asked to select the emotions that they experienced.  Feelings were categorized as positive (e.g. euphoria, happiness, self-confident), neutral (e.g. nothing, normal), or negative (e.g. depressed, sad, sick). Responses were collected and entered into Systat for analysis.

Results: The MAT and Comparison groups were indistinguishable in terms of sex, age, and race/ethnicity. The MAT group felt more positive feelings with first usage of alcohol and opioids compared to the comparison group (p < .001).  With first usage of opioids specifically, MAT (0.13 + 0.04) and Comparison (0.29 + 0.07, p < .001) groups differed.  Over half (55.3%), of the MAT participants reported feeling self-confident with first use of alcohol while only 29.7% of the Comparison reported this (p < .001).  Over three-fifths (63.7%) of the MAT group reported feeling euphoria with the first usage of opioids compared to one-tenth (9.8%) in the Comparison group (p < .001). 

Conclusions: This retrospective cross-sectional report shows that the first affective responses to recreational drugs may predict risk for future drug misuse potentially leading to SUD. Reporting positive feelings with first usage of alcohol and/or opioids could be used as a screening tool for patients who may be more prone to developing AUD and/or SUD.

What will audience learn from your presentation?

At the conclusion of this presentation the learner will be able to:

1. Discuss the warning signs for someone at risk for developing a Substance Use Disorder.
2. Teach other providers the warning signs for persons developing a Substance Use Disorder.
3. Safely prescribe substances for pain management.
4. Advise patients about risks related to various substances and developing a Substance Use Disorder.

Biography:

Dr. Karen E. Arscott is a board-certified addiction medicine specialist at The Wright Center for Community Health in Northeast Pennsylvania. She earned her Doctor of Osteopathic Medicine and Master of Clinical Science degrees from the Philadelphia College of Osteopathic Medicine. She is fellowship-trained, and board certified in addiction medicine by the American Board of Preventative Medicine. In addition, she is board certified in Neuromuscular medicine by the AOBNMM. Also, an Associate Professor of Medicine at Geisinger Commonwealth School of Medicine, president of the Lackawanna County Medical Society, and Board member of the Pennsylvania Osteopathic Medical Association.