Screening for Adolescent Alcohol Use in the Emergency Department: What Does It Tell Us About Cannabis, Tobacco, and Other Drug Use?

for the Pediatric Emergency Care Research Network (PECARN)

doi:10.1080/10826084.2018.1558251

Screening for Adolescent Alcohol Use in the Emergency Department: What Does It Tell Us About Cannabis, Tobacco, and Other Drug Use?

for the Pediatric Emergency Care Research Network (PECARN)

Pediatrics

Research output: Contribution to journal › Article › peer-review

6 Scopus citations

Abstract

Background: The pediatric emergency department (PED) represents an opportune time for alcohol and drug screening. The National Institute of Alcohol Abuse and Alcoholism (NIAAA) recommends a two-question alcohol screen for adolescents as a predictor of alcohol and drug misuse. Objective: A multi-site PED study was conducted to determine the association between the NIAAA two-question alcohol screen and adolescent cannabis use disorders (CUD), cigarette smoking, and lifetime use of other drugs. Methods: Participants included 12–17-year olds (n = 4834) treated in one of 16 participating PEDs. An assessment battery, including the NIAAA two-question screen and other measures of alcohol, tobacco and drug use, was self-administered on a tablet computer. Results: A diagnosis of CUD, lifetime tobacco use or lifetime drug use was predicted by any self-reported alcohol use in the past year, which indicates a classification of moderate risk for middle school ages and low risk for high school ages on the NIAAA two-question screen. Drinking was most strongly predictive of a CUD, somewhat weaker for lifetime tobacco use, and weakest for lifetime drug use. This same pattern held for high school and middle school students and was stronger for high school students over middle school students for all three categories. This association was also found across gender, ethnicity and race. The association was strongest for CUD for high school students, sensitivity 81.7% (95% CI, 77.0, 86.5) and specificity 70.4% (95% CI, 68.6, 72.1). Conclusions/Importance: A single question about past year alcohol use can provide valuable information about other substance use, particularly marijuana.

Original language	English (US)
Pages (from-to)	1007-1016
Number of pages	10
Journal	Substance Use and Misuse
Volume	54
Issue number	6
DOIs	https://doi.org/10.1080/10826084.2018.1558251
State	Published - May 12 2019

Funding

All phases of this study were supported in part by NIAAA 1R01AA021900 to A Spirito and JG Linakis. This project is supported in part by the Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB), Emergency Medical Services for Children (EMSC) Network Development Demonstration Program under cooperative agreement number U03MC00008, and is partially support by MCHB cooperative agreements: U03MC00001, U03MC00003, U03MC00006, U03MC00007, U03MC22684, and U03MC22685. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government. All phases of this study were supported in part by NIAAA 1R01AA021900 to A Spirito and JG Linakis. This project is supported in part by the Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB), Emergency Medical Services for Children (EMSC) Network Development Demonstration Program under cooperative agreement number U03MC00008, and is partially support by MCHB cooperative agreements: U03MC00001, U03MC00003, U03MC00006, U03MC00007, U03MC22684, and U03MC22685. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government. The authors wish to acknowledge the Pediatric Emergency Care Applied Research Network (PECARN) and the participating PECARN sites including: Baylor College of Medicine/Texas Children?s Hospital; Boston Children's Hospital; The Children's Hospital of Philadelphia; Children's National Medical Center; Cincinnati Children's Hospital Medical Center; Columbia University/Children?s Hospital of New York-Presbyterian; Hasbro Children?s Hospital; Lurie Children's Hospital of Chicago; Medical College of Wisconsin; Nationwide Children's Hospital; Nemours/Alfred I. duPont Hospital for Children; St. Louis Children?s Hospital/Washington University; University of California, Davis Children?s Hospital?Colorado; University of Michigan, University of Pittsburgh/Children's Hospital of Pittsburgh of UPMC. Our efforts would not have been possible without the commitment of the investigators and research coordinators from these sites. We also thank the PECARN Steering Committee members: R. Stanley (chair), B. Bonsu, C. Macias, D. Brousseau, D. Jaffe, D. Nelson, E. Alpern, E. Powell, J. Chamberlain, J. Bennett, J. M. Dean, L. Bajaj, L. Nigrovic, N. Kuppermann, P. Dayan, P. Mahajan, R. Ruddy and R. Hickey. A special thanks to the staff at the Data Coordinating Center including: H. Gramse, S. Zuspan, J. Wang, J. M. Dean, M. Ringwood and T. Simmons for their dedication and assistance throughout the study. Lastly, the authors wish to thank the participants and their parents for participating in this study.

Keywords

Alcohol screening
adolescent
marijuana
other drugs
pediatric emergency department
tobacco

ASJC Scopus subject areas

Medicine (miscellaneous)
Health(social science)
Public Health, Environmental and Occupational Health
Psychiatry and Mental health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1080/10826084.2018.1558251

Cite this

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title = "Screening for Adolescent Alcohol Use in the Emergency Department: What Does It Tell Us About Cannabis, Tobacco, and Other Drug Use?",

abstract = "Background: The pediatric emergency department (PED) represents an opportune time for alcohol and drug screening. The National Institute of Alcohol Abuse and Alcoholism (NIAAA) recommends a two-question alcohol screen for adolescents as a predictor of alcohol and drug misuse. Objective: A multi-site PED study was conducted to determine the association between the NIAAA two-question alcohol screen and adolescent cannabis use disorders (CUD), cigarette smoking, and lifetime use of other drugs. Methods: Participants included 12–17-year olds (n = 4834) treated in one of 16 participating PEDs. An assessment battery, including the NIAAA two-question screen and other measures of alcohol, tobacco and drug use, was self-administered on a tablet computer. Results: A diagnosis of CUD, lifetime tobacco use or lifetime drug use was predicted by any self-reported alcohol use in the past year, which indicates a classification of moderate risk for middle school ages and low risk for high school ages on the NIAAA two-question screen. Drinking was most strongly predictive of a CUD, somewhat weaker for lifetime tobacco use, and weakest for lifetime drug use. This same pattern held for high school and middle school students and was stronger for high school students over middle school students for all three categories. This association was also found across gender, ethnicity and race. The association was strongest for CUD for high school students, sensitivity 81.7% (95% CI, 77.0, 86.5) and specificity 70.4% (95% CI, 68.6, 72.1). Conclusions/Importance: A single question about past year alcohol use can provide valuable information about other substance use, particularly marijuana.",

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author = "{for the Pediatric Emergency Care Research Network (PECARN)} and Anthony Spirito and Bromberg, {Julie R.} and Casper, {T. Charles} and Thomas Chun and Mello, {Michael J.} and Mull, {Colette C.} and Shenoi, {Rohit P.} and Cheryl Vance and Fahd Ahmad and Lalit Bajaj and Brown, {Kathleen M.} and Chernick, {Lauren S.} and Cohen, {Daniel M.} and Joel Fein and Timothy Horeczko and Levas, {Michael N.} and B. McAninch and Monuteaux, {Michael C.} and Jackie Grupp-Phelan and Powell, {Elizabeth C} and Alexander Rogers and Brian Suffoletto and Linakis, {James G.}",

note = "Publisher Copyright: {\textcopyright} 2019, {\textcopyright} 2019 Taylor & Francis Group, LLC.",

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doi = "10.1080/10826084.2018.1558251",

language = "English (US)",

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T2 - What Does It Tell Us About Cannabis, Tobacco, and Other Drug Use?

AU - for the Pediatric Emergency Care Research Network (PECARN)

AU - Spirito, Anthony

AU - Bromberg, Julie R.

AU - Casper, T. Charles

AU - Chun, Thomas

AU - Mello, Michael J.

AU - Mull, Colette C.

AU - Shenoi, Rohit P.

AU - Vance, Cheryl

AU - Ahmad, Fahd

AU - Bajaj, Lalit

AU - Brown, Kathleen M.

AU - Chernick, Lauren S.

AU - Cohen, Daniel M.

AU - Fein, Joel

AU - Horeczko, Timothy

AU - Levas, Michael N.

AU - McAninch, B.

AU - Monuteaux, Michael C.

AU - Grupp-Phelan, Jackie

AU - Powell, Elizabeth C

AU - Rogers, Alexander

AU - Suffoletto, Brian

AU - Linakis, James G.

PY - 2019/5/12

Y1 - 2019/5/12

N2 - Background: The pediatric emergency department (PED) represents an opportune time for alcohol and drug screening. The National Institute of Alcohol Abuse and Alcoholism (NIAAA) recommends a two-question alcohol screen for adolescents as a predictor of alcohol and drug misuse. Objective: A multi-site PED study was conducted to determine the association between the NIAAA two-question alcohol screen and adolescent cannabis use disorders (CUD), cigarette smoking, and lifetime use of other drugs. Methods: Participants included 12–17-year olds (n = 4834) treated in one of 16 participating PEDs. An assessment battery, including the NIAAA two-question screen and other measures of alcohol, tobacco and drug use, was self-administered on a tablet computer. Results: A diagnosis of CUD, lifetime tobacco use or lifetime drug use was predicted by any self-reported alcohol use in the past year, which indicates a classification of moderate risk for middle school ages and low risk for high school ages on the NIAAA two-question screen. Drinking was most strongly predictive of a CUD, somewhat weaker for lifetime tobacco use, and weakest for lifetime drug use. This same pattern held for high school and middle school students and was stronger for high school students over middle school students for all three categories. This association was also found across gender, ethnicity and race. The association was strongest for CUD for high school students, sensitivity 81.7% (95% CI, 77.0, 86.5) and specificity 70.4% (95% CI, 68.6, 72.1). Conclusions/Importance: A single question about past year alcohol use can provide valuable information about other substance use, particularly marijuana.

AB - Background: The pediatric emergency department (PED) represents an opportune time for alcohol and drug screening. The National Institute of Alcohol Abuse and Alcoholism (NIAAA) recommends a two-question alcohol screen for adolescents as a predictor of alcohol and drug misuse. Objective: A multi-site PED study was conducted to determine the association between the NIAAA two-question alcohol screen and adolescent cannabis use disorders (CUD), cigarette smoking, and lifetime use of other drugs. Methods: Participants included 12–17-year olds (n = 4834) treated in one of 16 participating PEDs. An assessment battery, including the NIAAA two-question screen and other measures of alcohol, tobacco and drug use, was self-administered on a tablet computer. Results: A diagnosis of CUD, lifetime tobacco use or lifetime drug use was predicted by any self-reported alcohol use in the past year, which indicates a classification of moderate risk for middle school ages and low risk for high school ages on the NIAAA two-question screen. Drinking was most strongly predictive of a CUD, somewhat weaker for lifetime tobacco use, and weakest for lifetime drug use. This same pattern held for high school and middle school students and was stronger for high school students over middle school students for all three categories. This association was also found across gender, ethnicity and race. The association was strongest for CUD for high school students, sensitivity 81.7% (95% CI, 77.0, 86.5) and specificity 70.4% (95% CI, 68.6, 72.1). Conclusions/Importance: A single question about past year alcohol use can provide valuable information about other substance use, particularly marijuana.

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Screening for Adolescent Alcohol Use in the Emergency Department: What Does It Tell Us About Cannabis, Tobacco, and Other Drug Use?

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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