Letters Online screening for alcohol and other drug problems: an acceptable method for accessing help TO THE E DITOR : Alcohol and other drug (AOD)-related harms are considerable,1 yet individuals with AOD disorders are reluctant to seek treatment.2,3 Barriers to help-seeking include issues of stigma and a lack of understanding of what treatment involves. One possible approach to improving access is the use of online tools that provide advice about available help options. While online screening for alcohol has shown value as a complement to AOD-related treatment in a Swedish sample, limited work has been conducted examining such utility for AOD-related problems within an Australian context.4 From 4 December 2012 to 10 January 2013, an integrated online screening tool (comprising the Alcohol Use Disorders Identification Test, Drug Use Disorders Identification Test, Kessler Psychological Distress Scale [K10] and a three-point Likert scale measuring subjective quality of life) to identify problematic AOD use, psychological distress and subjective wellbeing, was posted on the Turning Point website (http://www.turning point.org.au) and promoted through Counselling Online (http://www. counsellingonline.org.au), a national 24/7 online counselling service for AOD issues. No identifying information was collected, and the research was approved by the Eastern Health Research and Ethics Committee. Participants completing the screen received individualised feedback about the severity of their reported AOD use and suggestions for seeking further support (eg, relevant self-help materials, online, telephone and face-to-face counselling). After 5 weeks of the pilot program, 288 screens were completed (from 900 website visits) of which 35.9% met criteria for likely alcohol dependence and 22.6% for likely drug dependence. Although overall physical health and quality of life scores were moderate, scores of psychological distress on the K10 indicated that 56.1% of respondents were experiencing high levels of psychological distress.5 Population demographics are shown in the Box.

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Basic demographics of Turning Point website users accessing online screening

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most site users (68.3%) were 20–44 years old; 47.4% were men, 51.9% were women and 0.7% reported “other” as their sex; 2.7% identified as Aboriginal and/or Torres Strait Islander; 71.8% reported their cultural background as Australian, followed by 8.7% European, 4.5% American, 3.8% British and 2.8% New Zealander; the tool had both national and international exposure: 93.4% of respondents were located in Australia (of those, 61.3% were in Victoria, 14.3% in New South Wales, 8.0% in Queensland, 4.2% in South Australia, 4.2% in Western Australia and 0.7% in Tasmania; 7.3% did not specify their state), 4.2% were in the United States, 0.7% were in the United Kingdom and 0.3% each in Canada, New Zealand and Kenya; the respondents’ education level was high: 56.8% completed university, 20.5% had a secondary education, 18.2% had attained a diploma and 4.5% had a trade certificate; 75% were employed; of those, 63% were in full-time employment, 24.2% part-time and 12.2% casual; and 38.6% had children. ◆

All participants reported that the screen was helpful and acceptable in length, and provided a positive experience in clarifying further help options. Almost half (47.8%) of the participants reported they would seek further professional support after completing the screen, as directed by the help options provided. The results show that an integrated online screening package may increase access to professional support for atrisk populations. It provides an acceptable and accessible mechanism for self-screening, acting as a bridge to a diverse range of treatment and support options for nearly half of all those screened. Ann S Wilson Research Fellow1 David W Best Associate Professor of Addiction Studies1.2

Michael Savic Research Fellow 1 Dan I Lubman Director,1 and Professor of Addiction Studies and Services 2 1 Turning Point Alcohol and Drug Centre, Melbourne, VIC. 2 Monash University, Melbourne, VIC.

[email protected] Competing interests: No relevant disclosures.

doi: 10.5694/mja13.10219 1 Rehm J, Taylor B, Room R. Global burden of disease from alcohol, illicit drugs and

tobacco. Drug Alcohol Rev 2006; 25: 503-513. 2 Mojtabai R, Crum RM. Perceived unmet need for alcohol and drug use treatments

and future use of services: results from a longitudinal study. Drug Alcohol Depend 2013; 127: 59-64. 3 Reavley NJ, Cvetkovski S, Jorm AF, Lubman DI. Help-seeking for substance use, anxiety and affective disorders among young people: results from the 2007 Australian National Survey of Mental Health and Wellbeing. Aust N Z J Psychiatry 2010; 44: 729-735. 4 Sinadinovic K, Berman AH, Hasson D, Wennberg P. Internet-based assessment and self-monitoring of problematic alcohol and drug use. Addict Behav 2010; 35: 464-470. 5 Kessler RC, Andrews G, Colpe L, et al. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med 2002; 32: 959-976. ❏

Online screening for alcohol and other drug problems: an acceptable method for accessing help.

Letters Online screening for alcohol and other drug problems: an acceptable method for accessing help TO THE E DITOR : Alcohol and other drug (AOD)-re...
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