Motivational Interviewing: Preparing People for Change

Trends in Medical Use, Diversion, and Nonmedical Use of Prescription Medications among College Students from 2003 to 2013: Connecting the Dots

Objective: Binge drinking (also called heavy episodic drinking, risky single-occasion drinking etc) is a major public health problem This paper provides an overview of recently published evidence

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Binge drinking: Health impact, prevalence, correlates and interventions

Psychology & Health ISSN: 0887-0446 (Print) 1476-8321 (Online) Journal homepage: http://www.tandfonline.com/loi/gpsh20 Binge drinking: Health impact, prevalence, correlates and interventions Emmanuel Kuntsche, Sandra Kuntsche, Johannes Thrul & Gerhard Gmel To cite this article: Emmanuel Kuntsche, Sandra Kuntsche, Johannes Thrul & Gerhard Gmel (2017): Binge drinking: Health impact, prevalence, correlates and interventions, Psychology & Health, DOI: 10.1080/08870446.2017.1325889 To link to this article: http://dx.doi.org/10.1080/08870446.2017.1325889 Published online: 17 May 2017. Submit your article to this journal Article views: 2 View related articles View Crossmark data Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=gpsh20 Download by: [UCSF Library] Date: 19 May 2017, At: 21:35

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Binge drinking: Health impact, prevalence,correlates and interventions - eScholarship

Background: Electronic screening and brief intervention (eSBI) has been shown to reduce alcohol consumption, but its effectiveness over time has not been subject to meta-analysis. Objective: The current study aims to conduct a systematic review and meta-analysis of the available literature to determine the effectiveness of eSBI over time in nontreatment-seeking hazardous/harmful drinkers. Methods: A systematic review and meta-analysis of relevant studies identified through searching the electronic databases PsychINFO, Medline, and EMBASE in May 2013. Two members of the study team independently screened studies for inclusion criteria and extracted data. Studies reporting data that could be transformed into grams of ethanol per week were included in the meta-analysis. The mean difference in grams of ethanol per week between eSBI and control groups was weighted using the random-effects method based on the inverse-variance approach to control for differences in sample size between studies. Results: There was a statistically significant mean difference in grams of ethanol consumed per week between those receiving an eSBI versus controls at up to 3 months (mean difference –32.74, 95% CI –56.80 to –8.68, z=2.67, P=.01), 3 to less than 6 months (mean difference –17.33, 95% CI –31.82 to –2.84, z=2.34, P=.02), and from 6 months to less than 12 months follow-up (mean difference –14.91, 95% CI –25.56 to –4.26, z=2.74, P=.01). No statistically significant difference was found at a follow-up period of 12 months or greater (mean difference –7.46, 95% CI –25.34 to 10.43, z=0.82, P=.41). Conclusions: A significant reduction in weekly alcohol consumption between intervention and control conditions was demonstrated between 3 months and less than 12 months follow-up indicating eSBI is an effective intervention.

The Effectiveness of Electronic Screening and Brief Intervention for Reducing Levels of Alcohol Consumption: A Systematic Review and Meta-Analysis

OBJECTIVE: Brief intervention (BI) is recommended for use with youth who use alcohol and other drugs. Emergency departments (EDs) can provide BIs at a time directly linked to harmful and hazardous use. The objective of this systematic review was to determine the effectiveness of ED-based BIs. METHODS: We searched 14 electronic databases, a clinical trial registry, conference proceedings, and study references. We included randomized controlled trials with youth 21 years or younger. Two reviewers independently selected studies and assessed methodological quality. One reviewer extracted and a second verified data. We summarized findings qualitatively. RESULTS: Two trials with low risk of bias, 2 trials with unclear risk of bias, and 5 trials with high risk of bias were included. Trials evaluated targeted BIs for alcohol-positive (n = 3) and alcohol/other drug-positive youth (n = 1) and universal BIs for youth reporting recent alcohol (n = 4) or cannabis use (n = 1). Few differences were found in favor of ED-based BIs, and variation in outcome measurement and poor study quality precluded firm conclusions for many comparisons. Universal and targeted BIs did not significantly reduce alcohol use more than other care. In one targeted BI trial with high risk of bias, motivational interviewing (MI) that involved parents reduced drinking quantity per occasion and high-volume alcohol use compared with MI that was delivered to youth only. Another trial with high risk of bias reported an increase in abstinence and reduction in physical altercations when youth received peer-delivered universal MI for cannabis use. In 2 trials with unclear risk of bias, MI reduced drinking and driving and alcohol-related injuries after the ED visit. Computer-based MI delivered universally in 1 trial with low risk of bias reduced alcohol-related consequences 6 months after the ED visit. CONCLUSIONS: Clear benefits of using ED-based BI to reduce alcohol and other drug use and associated injuries or high-risk behaviours remain inconclusive because of variation in assessing outcomes and poor study quality. Language: en

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Brief emergency department interventions for youth who use alcohol and other drugs: a systematic review.

Context: Alcohol and other drug (AOD) misuse by youth is a significant public health concern Unanticipated treatment for AOD-related morbidities is often sought in hospital emergency departments (EDs) Screening instruments that rapidly identify patients who require further diagnostic evaluation and/or brief intervention are critically important Objective: To summarize evidence on screening instruments that can assist emergency care clinicians in identifying AOD misuse in pediatric patients Methods: Fourteen electronic databases (including Medline, Embase, and PsycINFO) and reference screening were used Psychometric and prospective diagnostic studies were selected if the instrument focused on detecting AOD misuse in patients aged 21 years or younger in the ED Two reviewers independently assessed quality and extracted data Validity and reliability data were collected for psychometric studies Instrument performance was assessed by using sensitivity, specificity, and positive (LR(+)) and negative (LR(-)) likelihood ratios Meta-analysis was not possible because of clinical and measurement heterogeneity Results: Of the 1545 references initially identified, 6 studies met inclusion criteria; these studies evaluated 11 instruments for universal or targeted screening of alcohol misuse Instruments based on diagnostic criteria for AOD disorders were effective in detecting alcohol abuse and dependence (sensitivity: 088; specificity: 090; LR(+): 880) and cannabis use disorder (sensitivity: 096; specificity: 086; LR(+): 683) Conclusions: On the basis of the current evidence, we recommend that emergency care clinicians use a 2-question instrument for detecting youth alcohol misuse and a 1-question instrument for detecting cannabis misuse Additional research is required to definitively answer whether these tools should be used as targeted or universal screening approaches in the ED Language: en

Instruments to Detect Alcohol and Other Drug Misuse in the Emergency Department: A Systematic Review

Objective: This paper describes patient and treatment characteristics of pediatric mental health Emergency Department (ED) visits associated with alcohol and other drug (AOD) use. Method: A medical record and administrative database review was conducted. Proportional allocation random stratified sampling identified a representative sample of pediatric (18 years) mental health presentations to two tertiary care EDs between April 2004 and March 2006. Descriptive statistics were used to summarize data from 161 patients with associated AOD use. Results: More females (56.5%) and youth aged 15 to 18 years (70.8%) attended the ED for mental health complaints associated with AOD use. Alcohol (48.4%) and over-the-counter or prescription medications (25.5%) were the most commonly used substances. Twenty-four percent of patients had a documented psychiatric history. The most common psychiatric assessments provided were for suicidality (31.1%) and mood (18.0%). Brief counselling was provided in 31.7% of visits. Consultation with psychiatry occurred less than 20% of the time. Most patients were discharged from the ED (65.2%). Sixty-eight percent of patient records did not have documented discharge planning. Conclusions: When youth present to the ED for mental health concerns related to AOD use, mental health assessments and follow-up care are not occurring in all cases and reasons for this oversight need to be explored.

A Description of Emergency Care Received by Children and Youth with Mental Health Presentations for Alcohol and Other Drug use in two Alberta Emergency Departments.

Nicole Ata

Papers

Brief emergency department interventions for youth who use alcohol and other drugs: a systematic review.

Instruments to Detect Alcohol and Other Drug Misuse in the Emergency Department: A Systematic Review

A Description of Emergency Care Received by Children and Youth with Mental Health Presentations for Alcohol and Other Drug use in two Alberta Emergency Departments.