Utility of the AUDIT for screening adolescents for problematic alcohol use in the emergency department.

The emergency department is a setting conducive to screening adolescents for problematic alcohol use, who can then be targeted for further evaluation and intervention. This study examined the utility of the Alcohol Use Disorders Identification Test (AUDIT) as a screening measure for identifying young adolescents in an urban emergency department (ED). Adolescents (13-17 years old) who presented to the ED were screened as part of a larger study. A total of 859 adolescents, who denied alcohol use prior to their ED visit were administered the AUDIT. Of the 500 younger adolescents (13-15 years old), approximately 4% (n=22) were classified as AUDIT-positive using a cut-score of four or greater. Of the 359 older adolescents (16-17 years old), almost 19% (n=67) were classified as AUDIT-positive. The ability of shorter versions of the AUDIT to identify AUDIT-positive adolescents (as classified by the 10-item AUDIT using a cut-score of four or greater) was also explored. Since the adolescents in the current study were not alcohol-positive at the time of the ED visit, they would likely have been missed by biochemical alcohol screening alone. Screening procedures that employ the AUDIT may be most efficient when adapted for the specific adolescent age group (younger versus older), thus identifying the highest number of adolescents who should be targeted for intervention. Lowering the recommended adult cut-scores on the shorter versions of the AUDIT appears necessary to identify adolescents who may benefit from intervention or referral.

The effects of chronic nicotine and alcohol use on neurocognitive function.

Despite the extensive literatures on the independent effects of chronic nicotine and alcohol use on neurocognition, little is known about their combined impact. The purpose of this paper was to examine the effects of chronic nicotine and alcohol use on neurocognition in participants who took part in Project MATCH, a study of the efficacies of three behavioral treatments for adults diagnosed with alcohol abuse or dependence. Multiple regression and ANCOVA analyses were conducted to determine the relationship between lifetime weeks of tobacco use and years of alcohol use problems and neuropsychological test performance. Results showed that although years of chronic alcohol use was significantly inversely related to neuropsychological test scores, and chronic nicotine use showed an additive effect, substance use accounted for little variance in neuropsychological functioning. These findings suggest that some protective factors may have helped to attenuate the impact of chronic substance use on neurocognition. The importance of considering individual differences in such research is highlighted. Additional studies on the combined effects of chronic nicotine and alcohol use on neuropsychological function are warranted.