ABSTRACT
OBJECTIVE: The aim of this study was to test the efficacy of brief physician advice in reducing alcohol use and related harm in college students. METHOD: The College Health Intervention Projects (CHIPs) is a randomized, controlled clinical trial with 12-month follow-up conducted in five college health clinics in Wisconsin; Washington state; and Vancouver, Canada. Of the 12,900 students screened for high-risk drinking, 484 men and 502 women met inclusion criteria and were randomized into a control (n = 493) or intervention (n = 493) group. Ninety-six percent of students participated in the follow-up procedures. The intervention consisted of two 15-minute counseling visits and two follow-up phone calls, and used motivational interviewing, contracting, diary cards, and take-home exercises. RESULTS: No significant differences were found between groups at baseline on alcohol use, age, socioeconomic or smoking status, rates of depression, or measures of alcohol-related harm. At 12 months, the experimental subjects reduced their 28-day drinking totals by 27.2%, and the control group reduced their totals by 21%. A mixed effects repeated measures model found a statistical difference in favor of the brief-intervention group (beta = 4.7, SE = 2.0, p = .018) in 28-day drinking totals. The total Rutgers Alcohol Problem Index score was also significantly different during the 12-month follow-up period (beta = 0.8, SE = 0.4, p = .033). There was no difference on the other outcome measures of interest, such as frequency of excessive heavy drinking, health care utilization, injuries, drunk driving, depression, or tobacco use. CONCLUSIONS: The study supports resource allocation and implementation of alcohol screening and brief physician advice in primary care-based college health clinics.
Subject(s)
Alcohol Drinking/therapy , Counseling , Physician's Role , Physician-Patient Relations , Student Health Services , Universities , Adolescent , Alcohol Drinking/psychology , Counseling/methods , Female , Follow-Up Studies , Humans , Male , Patient Education as Topic/methods , Physician's Role/psychology , Primary Health Care/methods , Student Health Services/methods , Young AdultABSTRACT
Accidents stemming from alcohol-impaired driving are the leading cause of injury and death among college students. Research has implicated certain driver personality characteristics in the majority of these motor vehicle crashes. Sensation seeking in particular has been linked to risky driving, alcohol consumption, and driving while intoxicated. This study investigated the effect of sensation seeking on self-reported alcohol-impaired driving behavior in a college student population while adjusting for demographics, residence and drinking locations. A total of 1587 college students over the age of 18 completed a health screening survey while presenting for routine, non-urgent care at campus heath services centers. Student demographics, living situation, most common drinking location, heavy episodic drinking, sensation-seeking disposition and alcohol-impaired driving behavior were assessed. Using a full-form logistic regression model to isolate sensation seeking after adjusting for covariates, sensation seeking remains a statistically significant independent predictor of alcohol-impaired driving behavior (OR=1.52; CI=1.19-1.94; p<0.001). Older, white, sensation-seeking college students who engage in heavy episodic drinking, live off-campus, and go to bars are at highest risk for alcohol-impaired driving behaviors. Interventions should target sensation seekers and environmental factors that mediate the link between sensation seeking and alcohol-impaired driving behaviors.
Subject(s)
Alcohol Drinking/epidemiology , Alcoholic Intoxication/epidemiology , Automobile Driving/statistics & numerical data , Risk-Taking , Students , Adolescent , Adult , Age Factors , Cohort Studies , Female , Humans , Male , Odds Ratio , Prevalence , Risk Factors , Sex Factors , Student Health Services , United States/epidemiology , Young AdultABSTRACT
UNLABELLED: The primary goal of this paper was to present a comprehensive picture of substance use disorders in a sample of patients receiving opioid therapy from their primary care physician. A second goal was to determine the relation of positive urine screens and aberrant drug behaviors to opioid use disorders. The study recruited 801 adults receiving daily opioid therapy from the primary care practices of 235 family physicians and internists in 6 health care systems in Wisconsin. The 6 most common pain diagnoses were degenerative arthritis, low back pain, migraine headaches, neuropathy, and fibromyalgia. The point prevalence of current (DSM-IV criteria in the past 30 days) substance abuse and/or dependence was 9.7% (n=78) and 3.8% (30) for an opioid use disorder. A logistic regression model found that current substance use disorders were associated with age between 18 and 30 (OR=6.17: 1.99 to 19.12), severity of lifetime psychiatric disorders (OR=6.17; 1.99 to 19.12), a positive toxicology test for cocaine (OR=5.92; 2.60 to 13.50) or marijuana (OR=3.52; 1.85 to 6.73), and 4 aberrant drug behaviors (OR=11.48; 6.13 to 21.48). The final model for opioid use disorders was limited to aberrant behaviors (OR=48.27; 13.63 to 171.04) as the other variables dropped out of the model. PERSPECTIVE: This study found that the frequency of opioid use disorders was 4 times higher in patients receiving opioid therapy compared with general population samples (3.8% vs 0.9%). The study also provides quantitative data linking aberrant drug behaviors to opioid use disorders.
