Substance Abuse 2021;42(4):487-492. [doi: 10.1080/08897077.2021.1901176]
John, William S. | Zhu, He | Greenblatt, Lawrence H. | Wu, Li-Tzy
Primary care settings provide salient opportunities for identifying patients with problematic substance use and addressing unmet treatment needs. The aim of this study was to examine the extent and correlates of problematic substance use by substance-specific risk categories among primary care patients to inform screening/intervention efforts.
This secondary analysis of CTN-0059 (TAPS Tool) looked at data from 2000 adult primary care patients aged 18 or older (56% female) across 5 clinics in the eastern U.S. Participants completed the Alcohol, Smoking, and Substance Invovement Screening Test (ASSIST). Prevalence and ASSIST-defined risk-level of tobacco use, alcohol use, and nonmedical/illicit drug use was examined. Multinomial logistic regression models analyzed the demographic correlates of substance use risk-levels.
Among the total sample, the prevalence of any past 3-month use was 53.9% for alcohol, 42% for tobacco, 24.2% for any illicit/Rx drug, and 5.3% for opioids; the prevalence of ASSIST-defined moderate/high-risk use was 45.1% for tobacco, 29% for any illicit/Rx drug, 14.2% for alcohol, and 9.1% for opioids. Differences in the extent and risk-levels of substance use by sex, race/ethnicity, and age group were observed. Adjusted logistic regression showed that male sex, white race, not being married, and having less education were associated with increased odds of moderate/high-risk use scores for each substance category; older ages (versus ages 18-25 years) were associated with increased odds of moderate/high-risk opioid use.
Conclusions: Intervention need for problematic substance use was prevalent in this sample. Providers should maintain awareness and screen for problematic substance use more consistently in identified high risk populations.
Keywords: Alcohol | CTN platform/ancillary study | Opioid use disorder | Primary care | Screening and assessment instruments | Smoking | Substance Abuse (journal)
Document No: 1448 ; PMID: 33797348 ; PMCID: PMC9822781
Submitted by: CTN Dissemination Librarian (4/6/2021)
