Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #109997

Margaret L. Griffin, PhD¹, Roger D. Weiss, MD¹, Monika Kolodziej, PhD¹, Irene Janis, AB², and Rachel Bender, AB². (1) McLean Hospital, Harvard University, 115 Mill Street, Belmont, MA 02478, 617-855-2768, mgriffin@mclean.harvard.edu, (2) Alcohol and Drug Abuse Treatment Center, McLean Hospital, 115 Mill Street, Belmont, MA 02478

Few substance abusers limit their intake to one drug; however, many studies focus on a single drug, potentially trading generalizability for methodological clarity. The most reliable way to determine the primary substance is unclear, particularly in patients with psychiatric illness. We compared different methods for assessing primary substance of abuse in 104 patients with bipolar and substance disorders. Patients completed two interviews, the Addiction Severity Index (ASI) and the Structured Clinical Interview for DSM-IV (SCID), and a self-administered questionnaire. The ASI asks, “Which substance is the major problem?” The questionnaire asks, “What is the primary substance (drug or alcohol) that you use?” and “Second preferred drug, if any?” Comparison of the measures showed that the prevalence of problems with both alcohol and drugs was three times greater (40% vs. 12%) when using the questionnaire rather than the ASI data. Further analyses showed that the prevalence of problems with particular drugs was greater for each category according to the questionnaire data, compared to the ASI. While the SCID confirmed that patients were currently dependent on the substance considered primary according to both the ASI and the questionnaire, patients were also currently dependent on many additional substances. These findings suggest that apparently small differences in the methodology of assessing primary substance of abuse can yield different results, hindering treatment evaluation. Hence substance abuse studies may benefit from using more than one measure to increase reliability of assessing primary substance of abuse, or focusing less on a single substance of abuse.

Learning Objectives:

At the conclusion of the presentation, the participant will be able to
• Discuss the implications of errors in assessing primary substance of abuse
• Evaluate the strengths and weaknesses of different measures of primary substance of abuse

Keywords: Drug Abuse, Treatment

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.