Substance Use Disorder Risk Assessment

Abstract: 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.