James G Linakis1, Sarah A Thomas2, Julie R Bromberg3, T Charles Casper4, Thomas H Chun1,3, Michael J Mello1,3, Rachel Richards4, Fahd Ahmad5, Lalit Bajaj6, Kathleen M Brown7, Lauren S Chernick8, Daniel M Cohen9, J Michael Dean4, Joel Fein10, Timothy Horeczko11, Michael N Levas12, B McAninch13, Michael C Monuteaux14, Colette C Mull15, Jackie Grupp-Phelan16, Elizabeth C Powell17, Alexander Rogers18, Rohit P Shenoi19, Brian Suffoletto13, Cheryl Vance20, Anthony Spirito2. 1. Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA. 2. Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA. 3. Department of Emergency Medicine, Rhode Island Hospital, Providence, Rhode Island, USA. 4. University of Utah, Salt Lake City, Utah, USA. 5. Emergency Medicine, St. Louis Children's Hospital/Washington University, St Louis, Missouri, USA. 6. Children's Hospital - Colorado, Aurora, Colorado, USA. 7. Emergency Medicine and Trauma Services, Children's National Medical Center, Washington, Washington, D.C., USA. 8. Emergency Medicine, Columbia University Medical Center, New York, New York, USA. 9. Nationwide Children's Hospital, Columbus, Ohio, USA. 10. The Children's Hospital of Philadelphia, Philadephia, Pennsylvania, USA. 11. Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, California, USA. 12. Medical College of Wisconsin, Milwaukee, Wisconsin, USA. 13. Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. 14. Boston Children's Hospital, Boston, Massachusetts, USA. 15. Sidney Kimmel Medical College, Jefferson University/Nemours Alfred I. duPont Hospital for Children, Wilmington, Delaware, USA. 16. Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA. 17. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA. 18. University of Michigan, Ann Arbor, Michigan, USA. 19. Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA. 20. University of California of Davis, Davis, California, USA.
Abstract
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 = 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.
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 = 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.
Authors: James G Linakis; Julie R Bromberg; T Charles Casper; Thomas H Chun; Michael J Mello; Hailey Ingebretsen; Anthony Spirito Journal: J Pediatr Date: 2019-04-06 Impact factor: 4.406
Authors: Michael M Vanyukov; Ralph E Tarter; Galina P Kirillova; Levent Kirisci; Maureen D Reynolds; Mary Jeanne Kreek; Kevin P Conway; Brion S Maher; William G Iacono; Laura Bierut; Michael C Neale; Duncan B Clark; Ty A Ridenour Journal: Drug Alcohol Depend Date: 2012-01-18 Impact factor: 4.492
Authors: Megan E Patrick; Deborah D Kloska; Yvonne M Terry-McElrath; Christine M Lee; Patrick M O'Malley; Lloyd D Johnston Journal: Am J Drug Alcohol Abuse Date: 2017-12-20 Impact factor: 3.829
Authors: James G Linakis; Julie R Bromberg; T Charles Casper; Thomas H Chun; Michael J Mello; Rachel Richards; Colette C Mull; Rohit P Shenoi; Cheryl Vance; Fahd Ahmad; Lalit Bajaj; Kathleen M Brown; Lauren S Chernick; Daniel M Cohen; Joel Fein; Timothy Horeczko; Michael N Levas; Brett McAninch; Michael C Monuteaux; Jackie Grupp-Phelan; Elizabeth C Powell; Alexander Rogers; Brian Suffoletto; J Michael Dean; Anthony Spirito Journal: Pediatrics Date: 2019-02-19 Impact factor: 7.124
Authors: Anthony Spirito; Julie R Bromberg; T Charles Casper; Thomas Chun; Michael J Mello; Colette C Mull; Rohit P Shenoi; Cheryl Vance; Fahd Ahmad; Lalit Bajaj; Kathleen M Brown; Lauren S Chernick; Daniel M Cohen; Joel Fein; Timothy Horeczko; Michael N Levas; B McAninch; Michael C Monuteaux; Jackie Grupp-Phelan; Elizabeth C Powell; Alexander Rogers; Brian Suffoletto; James G Linakis Journal: Subst Use Misuse Date: 2019-02-06 Impact factor: 2.164
Authors: P W Fisher; D Shaffer; J C Piacentini; J Lapkin; V Kafantaris; H Leonard; D B Herzog Journal: J Am Acad Child Adolesc Psychiatry Date: 1993-05 Impact factor: 8.829