Can Young Adults Accurately Self-Report Substance Abuse?

Can Young Adults Accurately Self-Report Substance Abuse?

Posted on June 13th, 2014
Posted in Substance Abuse

When doctors and other health professionals want to assess the risks for substance abuse in any given individual, they can use a well-regarded questionnaire called the Alcohol, Smoking and Substance Involvement Screening Test, or ASSIST. However, people do not typically use ASSIST as a tool for self-assessment outside of a visit to a doctor’s office. In a study scheduled for publication in July 2014 in the journal Addictive Behaviors, a team of Brazilian researchers sought to determine if young adults who take the ASSIST questionnaire on their own can accurately self-report behavior that may indicate the presence of substance abuse.

Young Adults and Substance Abuse

Early adulthood is a peak time for substance abuse, according to figures compiled by the federal Substance Abuse and Mental Health Services Administration. Out of all teenagers and adults in the U.S., young adults between the ages of 18 and 34 have the highest rates for a dangerous form of rapid alcohol consumption called binge drinking, as well as the highest rates for heavy or excessive monthly alcohol intake. Peak rates for the use/abuse of marijuana and other illegal or illicit drugs or medications also occur in young people between the ages of 18 and 25. In addition, young adults from 18 to 24 smoke cigarettes more often than younger teenagers or older adults. Regardless of their age, people who abuse drugs, alcohol or nicotine have sharply increased risks for developing substance use disorder, an officially recognized category of mental illness that includes both serious, non-addicted substance abuse and substance addiction.

ASSIST Questionnaire

The Alcohol, Smoking and Substance Involvement Screening Test was created by researchers and physicians working for the World Health Organization as a means to give doctors an accurate, culturally unbiased way to gauge the harmful impact of various forms of substance use on their patients’ health. Particular forms of substance use assessed by the questionnaire include drinking, marijuana/cannabis use, the use of cocaine and/or other addictive stimulants, opioid drug and medication use, inhalant use and hallucinogen use. When administering ASSIST to their patients, doctors ask eight questions that touch upon issues such as the types of substances consumed, recent frequency of substance intake, frequency of cravings for further substance use, frequency of any personal or social disruptions stemming from substance use and the loss of control over substance intake. ASSIST also probes the issue of injection drug use. On average, it takes five to 10 minutes to ask these questions and record the results.

Can Young Adults Accurately Self-Report?

Researchers from Brazil’s Federal University of Parana asked 170 young adults enrolled in college to take a modified form of the Alcohol, Smoking and Substance Involvement Screening Test designed to be completed without supervision from a health professional. The researchers chose to undertake this project, in part, in response to a growing need for the early detection of substance-related problems in people who may not have access to a doctor or may not choose to visit a doctor. Within a 30-day time period, all 170 study participants took both the modified form of ASSIST and the traditional form of the questionnaire administered professionally. After receiving the results from both tests, the researchers compared their accuracy on measurements that included involvement in substance use, cocaine intake, alcohol intake, marijuana/cannabis intake and tobacco/nicotine intake.

The researchers concluded that ASSIST tests taken independently have a “good to moderate” level of consistency from person to person when gauging involvement in marijuana/cannabis, cocaine, alcohol and tobacco/nicotine use. They also concluded that, when compared to ASSIST results obtained by a doctor or some other health professional, self-reported results are reasonably accurate and reliable. Overall, the researchers concluded that self-administered ASSIST tests can serve as an adequate substitute for professionally administered ASSIST tests.

Despite these findings, the study’s authors note several important differences between professionally administered ASSIST tests and self-administered ASSIST tests. First, the professionally administered tests still provide considerably more accurate results than tests taken without supervision. In addition, people who take a supervised version of the Alcohol, Smoking and Substance Involvement Screening Test exhibit a greater amount of worry about their substance-using behaviors, as well as a greater willingness to change substance-related behaviors that might cause them harm. Generally speaking, the students enrolled in the study liked the supervised version of the test more than they liked taking the test on their own.

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