Substance Use Disorder Risk Assessment: Preventing Use Disorder

Importance Current screening tools for Alcohol Use Disorder (AUD) or Substance Use Disorder (SUD) discover this disease at a late stage. Objective The goal of this study was to develop a simple prevention screening tool for patients who may be prone to develop AUD and/or SUD prior to the development of addiction. Design The study involved a self-administered survey type study using a cross-sectional design and was carried out in the spring of 2020 over a one-month period. Setting This study was completed at an urgent care facility which supports a separate Medication Assisted Treatment (MAT) clinic. Those patients who presented to the MAT clinic (SUD group) were seen in a separate area that the patients presenting for urgent care (Control group). Participants Participants (N = 259) were voluntarily recruited from MAT and Urgent care patients: Patients receiving acute care were assigned to the Control group (N = 126, 50.8% female, 5.7% non-white, 27.2 age < 34)) and those receiving treatment for SUD were assigned to the MAT group (N =133, 40.8% female, 4.8% non-white, 36.8% <34)). Main Outcome and Measure The survey questioned demographics (4 items), risk factors for AUD/SUD (6 items), information about first alcohol/opioid experiences (16 items), and factors for seeking AUD/SUD treatment and recovery (2 items). Feelings were categorized as positive (e.g., euphoria, happiness, self-confident), neutral (e.g., nothing, normal), or negative (e.g., depressed, sad, sick). Results The MAT group felt more positive feelings with first usage of alcohol and opioids compared to the control group (p<.001). With first usage of opioids specifically, MAT (0.13 + 0.04) and Control (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 Control reported this (p<.001). Over three-fifths (63.7%)of the MAT group reported feeling of euphoria with the first usage of opioids compared to one-tenth (9.8%) in the Control group (p<.001). Conclusions This retrospective cross-sectional report shows the first affective responses to substances may predict risk for future SUD and could be used as a prevention screening tool. Reporting positive feelings with first usage of alcohol and opioids could be used as a screening tool for patients who may be more prone to developing AUD and SUD. Key Points Question Is there a way to identify a person at risk for developing a substance use disorder? Findings In this retrospective cross-sectional study involving 259 participants it was significantly demonstrated that the first affective responses to recreational drugs may predict risk for future drug misuse potentially leading to SUD. The MAT group felt more positive feelings with first usage of alcohol and opioids compared to the comparison group (p < .001). Meaning If a patient develops a euphoric response to initial experience with a substance, they are significantly more likely to develop a substance use disorder.