Evidence map›Paper›PMID 38706328›Full record

ArticleThe American journal of psychiatry2024

Associations Between a Primary Care-Delivered Alcohol-Related Brief Intervention and Subsequent Opioid-Related Outcomes.

Dan V Blalock, Sophia A Berlin, Theodore Berkowitz, Valerie A Smith, Charles Wright, Rachel L Bachrach, Janet M Grubber

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The American journal of psychiatry, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Dan V BlalockDurham Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, N.C. (Blalock, Berkowitz, Smith, Grubber); Department of Psychiatry and Behavioral Sciences (Blalock) and Division of General Internal Medicine, Department of Medicine (Smith), Duke University School of Medicine, Durham, N.C.; Institute for Medical Research and Durham Veterans Affairs Health Care System, Durham, N.C. (Berlin); Department of Population Health Sciences, Duke University, Durham, N.C. (Smith); UNC Gillings School of Global Public Health, Chapel Hill (Wright); Center for Clinical Management Research, VA Ann Arbor Healthcare System, and Department of Psychiatry, University of Michigan Medical School, Ann Arbor (Bachrach); Cooperative Studies Program Coordinating Center, Veterans Affairs Boston Health Care System (Grubber).
Sophia A BerlinDurham Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, N.C. (Blalock, Berkowitz, Smith, Grubber); Department of Psychiatry and Behavioral Sciences (Blalock) and Division of General Internal Medicine, Department of Medicine (Smith), Duke University School of Medicine, Durham, N.C.; Institute for Medical Research and Durham Veterans Affairs Health Care System, Durham, N.C. (Berlin); Department of Population Health Sciences, Duke University, Durham, N.C. (Smith); UNC Gillings School of Global Public Health, Chapel Hill (Wright); Center for Clinical Management Research, VA Ann Arbor Healthcare System, and Department of Psychiatry, University of Michigan Medical School, Ann Arbor (Bachrach); Cooperative Studies Program Coordinating Center, Veterans Affairs Boston Health Care System (Grubber).
Theodore BerkowitzDurham Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, N.C. (Blalock, Berkowitz, Smith, Grubber); Department of Psychiatry and Behavioral Sciences (Blalock) and Division of General Internal Medicine, Department of Medicine (Smith), Duke University School of Medicine, Durham, N.C.; Institute for Medical Research and Durham Veterans Affairs Health Care System, Durham, N.C. (Berlin); Department of Population Health Sciences, Duke University, Durham, N.C. (Smith); UNC Gillings School of Global Public Health, Chapel Hill (Wright); Center for Clinical Management Research, VA Ann Arbor Healthcare System, and Department of Psychiatry, University of Michigan Medical School, Ann Arbor (Bachrach); Cooperative Studies Program Coordinating Center, Veterans Affairs Boston Health Care System (Grubber).
Valerie A SmithDurham Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, N.C. (Blalock, Berkowitz, Smith, Grubber); Department of Psychiatry and Behavioral Sciences (Blalock) and Division of General Internal Medicine, Department of Medicine (Smith), Duke University School of Medicine, Durham, N.C.; Institute for Medical Research and Durham Veterans Affairs Health Care System, Durham, N.C. (Berlin); Department of Population Health Sciences, Duke University, Durham, N.C. (Smith); UNC Gillings School of Global Public Health, Chapel Hill (Wright); Center for Clinical Management Research, VA Ann Arbor Healthcare System, and Department of Psychiatry, University of Michigan Medical School, Ann Arbor (Bachrach); Cooperative Studies Program Coordinating Center, Veterans Affairs Boston Health Care System (Grubber).
Charles WrightDurham Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, N.C. (Blalock, Berkowitz, Smith, Grubber); Department of Psychiatry and Behavioral Sciences (Blalock) and Division of General Internal Medicine, Department of Medicine (Smith), Duke University School of Medicine, Durham, N.C.; Institute for Medical Research and Durham Veterans Affairs Health Care System, Durham, N.C. (Berlin); Department of Population Health Sciences, Duke University, Durham, N.C. (Smith); UNC Gillings School of Global Public Health, Chapel Hill (Wright); Center for Clinical Management Research, VA Ann Arbor Healthcare System, and Department of Psychiatry, University of Michigan Medical School, Ann Arbor (Bachrach); Cooperative Studies Program Coordinating Center, Veterans Affairs Boston Health Care System (Grubber).
Rachel L BachrachDurham Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, N.C. (Blalock, Berkowitz, Smith, Grubber); Department of Psychiatry and Behavioral Sciences (Blalock) and Division of General Internal Medicine, Department of Medicine (Smith), Duke University School of Medicine, Durham, N.C.; Institute for Medical Research and Durham Veterans Affairs Health Care System, Durham, N.C. (Berlin); Department of Population Health Sciences, Duke University, Durham, N.C. (Smith); UNC Gillings School of Global Public Health, Chapel Hill (Wright); Center for Clinical Management Research, VA Ann Arbor Healthcare System, and Department of Psychiatry, University of Michigan Medical School, Ann Arbor (Bachrach); Cooperative Studies Program Coordinating Center, Veterans Affairs Boston Health Care System (Grubber).
Janet M GrubberDurham Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, N.C. (Blalock, Berkowitz, Smith, Grubber); Department of Psychiatry and Behavioral Sciences (Blalock) and Division of General Internal Medicine, Department of Medicine (Smith), Duke University School of Medicine, Durham, N.C.; Institute for Medical Research and Durham Veterans Affairs Health Care System, Durham, N.C. (Berlin); Department of Population Health Sciences, Duke University, Durham, N.C. (Smith); UNC Gillings School of Global Public Health, Chapel Hill (Wright); Center for Clinical Management Research, VA Ann Arbor Healthcare System, and Department of Psychiatry, University of Michigan Medical School, Ann Arbor (Bachrach); Cooperative Studies Program Coordinating Center, Veterans Affairs Boston Health Care System (Grubber).

Funding

Telehealth Treatment of Veterans with Alcohol Misuse at Risk for Cardiovascular DiseaseIK2HX003085 · VA · DURHAM VA MEDICAL CENTER · PI BLALOCK, DANIEL V · 2021 to 2025
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Implementation Intervention to Improve Care for Unhealthy Alcohol UseIK2HX003087 · VA · VETERANS HEALTH ADMINISTRATION · PI BACHRACH, RACHEL LAUREN · 2020 to 2025
–
HSRD VA IK2 HX003085HSRD VA IK2 HX003087
6 · The paper itself

Abstract

objectiveThe co-occurrence of unhealthy alcohol use and opioid misuse is high and associated with increased rates of overdose, emergency health care utilization, and death. The current study examined whether receipt of an alcohol-related brief intervention is associated with reduced risk of negative downstream opioid-related outcomes.

methodsThis retrospective cohort study included all VISN-6 Veterans Affairs (VA) patients with Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) screening results (N=492,748) from 2014 to 2019. Logistic regression was used to examine the association between documentation of an alcohol-related brief intervention and probability of a new 1) opioid prescription, 2) opioid use disorder (OUD) diagnosis, or 3) opioid-related hospitalization in the following year, controlling for demographic and clinical covariates.

resultsOf the veterans, 13% (N=63,804) had "positive" AUDIT-C screen results. Of those, 72% (N=46,216) had a documented alcohol-related brief intervention. Within 1 year, 8.5% (N=5,430) had a new opioid prescription, 1.1% (N=698) had a new OUD diagnosis, and 0.8% (N=499) had a new opioid-related hospitalization. In adjusted models, veterans with positive AUDIT-C screen results who did not receive an alcohol-related brief intervention had higher odds of new opioid prescriptions (adjusted odds ratio [OR]=1.10, 95% CI=1.03-1.17) and new OUD diagnoses (adjusted OR=1.19, 95% CI=1.02-1.40), while new opioid-related hospitalizations (adjusted OR=1.19, 95% CI=0.99-1.44) were higher although not statistically significant. Removal of medications for OUD (MOUD) did not impact associations. All outcomes were significantly associated with an alcohol-related brief intervention in unadjusted models.

conclusionsThe VA's standard alcohol-related brief intervention is associated with subsequent lower odds of a new opioid prescription or a new OUD diagnosis. Results suggest a reduction in a cascade of new opioid-related outcomes from prescriptions through hospitalizations.

Indexed as

AlcoholismOpioid-Related DisordersPrimary Health CareVeteransAdultAgedAnalgesics, OpioidFemaleHospitalizationHumansMaleMiddle AgedRetrospective StudiesUnited StatesUnited States Department of Veterans AffairsAnalgesics, OpioidAlcoholMental Health Care/Service Delivery SystemsOpioidsSubstance-Related and Addictive Disorders

Identifiers

PMID38706328
PMCPMC11076009

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.