Alcohol, drugs and health

Alcohol is the most common used drug in Norway. A large majority of the Norwegian population drinks alcohol, despite the negative effects on health, and where a high intake leads to a shorter life expectancy. Alcohol is related to over 200 different diseases and conditions, and it is one of the main contributing risk factors for illness, injury and premature death. Elderly people drink more alcohol now than before. Even at relatively low levels of alcohol consumption, older adults can be vulnerable due to age related physiological changes. In addition, elderly often have a concomitant use of medications that interact with alcohol. Alcohol is an organic compound and can affect all the organs of the body. It is classified as Group 1 carcinogen by the International Agency for Research on Cancer. The increased risk of cancer has been associated with both light (< 0.5 drink/day) and excessive alcohol use. Findings show that psychoactive medicinal drugs are used by over 30 % of hospitalized injury- and medically ill patients, and that they often use two or more of these substances. Polydrug use and long term use of psychoactive drugs can result in adverse health consequences including addiction and overdose risk. In addition, non-medicinal and problematic use increases the risk of morbidity and mortality further.

From a preventive health perspective, it is useful to be able to identify patients with risky alcohol use and problematic medicinal use, without necessarily meeting the criteria for an addiction diagnosis. It has been shown that a high consumption of alcohol and psychoactive medicinal drugs both increase the risk of complications and interfere with the course of treatment. To identify alcohol use, a short version of Alcohol Use Disorder Identification Test Consumption (AUDIT-C) is used and PEth, an alcohol biomarker, is measured in blood samples. Psychoactive substances both prescribed and used illegally are included in the blood sample screening as they interact with alcohol and may contribute to health deterioration both alone and in combination with alcohol and other drugs.

Reduction of a high alcohol consumption and problematic psychoactive drug use will be of health gain for patients both in short and long term.

The research group study health consequences of alcohol use and psychoactive medicinal drug use, mainly among hospitalized injury- and medically ill patients. In addition we are studying the impact of tailored treatment, barriers to address alcohol use and we are working on improving information on alcohol and psychoactive medicinal drug use for both patients and health personnel. In order to better understand the prevalence of alcohol and psychoactive medicinal drug use among patients, and the health outcome of a high intake or problematic use, several research projects on alcohol and psychoactive medicinal drugs are being performed.

Photo: Pixabay

Ongoing projects

AlcoTail
Screening for harmful alcohol and substance use among somatic patients and tailored interventions in Norwegian hospitals. The main aim of the study is to examine the implementation and effect of measures to reduce alcohol and drug use among Norwegian patients admitted to Medical Departments. As part of new guidelines at Norwegian hospitals, patients with potentially harmful consumption of alcohol and psychoactive drugs will be offered tailored intervention in the form of information, brief interventions and treatment. AlcoTail will be the first Norwegian study of the effect of such guidelines in Norwegian hospitals, i.e. OUS, St. Olavs Hospital Trust and Lovisenberg Diaconal Hospital.

Collaboration on alcohol and health in the Arctic region
This project will focus on harmful alcohol use in arctic regions of Greenland and Norway. This international collaboration is facilitated thru the NDPHS ASA group and Ministry of Health and Care services.

Collaboration on alcohol and health in the Barents region
This project will focus on harmful alcohol use among patients in hospitals in Estonia, Latvia and Lithuania. This international collaboration is facilitated thru the NDPHS ASA group and Ministry of Health and Care services.

Addressing harmful alcohol use in the healthcare service
Survey among health personnel addressing harmful alcohol use in the healthcare system. Development of alcohol information leaflet, in collaboration with TSB at OUS.

Surveillance of alcohol and drug use among hospitalized somatic patients
Screening for harmful alcohol use among somatic patients at Lovisenberg Diaconal Hospital. Further studies on patients with high alcohol intake with coupling of data from admissions, social and health registries.

Photo: Oslo University Hospital

Previous projects

Alcohol, drugs and somatic health
Psychoactive Drugs, Alcohol and Injuries

Project members

Stig Tore Bogstrand (Professor, Head of Research, PhD)
Anners Lerdal (Professor, Head of Research, Lovisenberg Diaconal Hospital)
Benedicte Jørgenrud (Coordinator, MSc)
Armika Nyman (Scientist, MSc Pharm)
Galina Nilsson (Engineer)
Sasa Katadzic (Administrative advisor)
Hilde Marie Erøy Edvardsen (Research Group Leader, MSc Pharm, PhD)
Saranda Kabashi (PhD-student, MSc)
Danil Gamboa (PhD-student, MD)
Maria Seferowicz (PhD-student, MD)
Annebeth Tisjø (PhD-student, MD)
Nina Auestad (PhD-student)

Past members

Eline Skadberg (Engineer 2016-2019)
Vigdis Vindenes (Head of Section, MD, PhD)

Collaboration

Anners Lerdal, Professor, Head of Research, Lovisenberg Diaconal Hospital
Gudmund Nordby, Head of medical department, Lovisenberg Diaconal Hospital
Merete Taksdal, Project manager, NK-TSB, Oslo University Hospital
National Center for Addictive Disorders, Lithuania
Estonian Health Insurance Fund (EHIF), Estonia
Centre for Disease Prevention and Control (CDPC), Latvia
The National Knowledge Center on Substance Abuse (Allorfik), Greenland
The Finnmark Hospital Trust, Norway

Information material - patient care

Alcohol Use and Health, a leaflet with information and recommendations

Press and Media Reports

Publications

Bråthen CC, Jørgenrud BM, Bogstrand ST, Gjerde H, Rosseland LA, Kristiansen T (2023)
Prevalence of use and impairment from drugs and alcohol among trauma patients: A national prospective observational study
Injury, 54 (12), 111160
DOI 10.1016/j.injury.2023.111160, PubMed 37944451

Wilson T, Wisborg T, Vindenes V, Jamt REG, Bogstrand ST (2023)
Psychoactive substances and previous hospital admissions, triage and length of stay in rural injuries: a prospective observational study
Scand J Trauma Resusc Emerg Med, 31 (1), 86
DOI 10.1186/s13049-023-01156-z, PubMed 38012704

Høiseth G, Vindenes V, Hilberg T, Bogstrand ST (2022)
[High level of ferritin and HDL cholesterol is associated with high alcohol consumption]
Tidsskr Nor Laegeforen, 142 (17)
DOI 10.4045/tidsskr.22.0431, PubMed 36416649

Maria MH, Jørgenrud BM, Berg T (2022)
Determination of eight phosphatidylethanol homologues in blood by reversed phase liquid chromatography-tandem mass spectrometry - How to avoid co-elution of phosphatidylethanols and unwanted phospholipids
J Chromatogr A, 1684, 463566
DOI 10.1016/j.chroma.2022.463566, PubMed 36306689

Nyman AAT, Vindenes V, Strøm RT, Katadzic S, Gustavsen I, Bogstrand ST (2022)
Systematic screening of substance use upon hospitalisation
Tidsskr Nor Laegeforen, 142 (14)
DOI 10.4045/tidsskr.22.0481, PubMed 36226432

Årving A, Hilberg T, Sovershaev M, Bogstrand ST, Høiseth G (2022)
Falsely low phosphatidylethanol may be associated with biomarkers of haemolytic disease
Basic Clin Pharmacol Toxicol, 132 (2), 223-230
DOI 10.1111/bcpt.13814, PubMed 36370095

Jørgenrud B, Kabashi S, Nadezhdin A, Bryun E, Koshkina E, Tetenova E, Lerdal A, Norby G, Kolgashkin A, Petukhov A, Perekhodov S, Davydova E, Vindenes V, Gamboa D, Bogstrand ST (2021)
The Association between the Alcohol Biomarker Phosphatidylethanol (PEth) and Self-Reported Alcohol Consumption among Russian and Norwegian Medical Patients
Alcohol Alcohol, 56 (6), 726-736
DOI 10.1093/alcalc/agab013, PubMed 33677484

Kabashi S, Gamboa D, Vindenes V, Berg T, Hilberg TA, Jørgenrud B, Lerdal A, Bogstrand ST (2021)
Multimorbidity, psychoactive substance use and psychological distress among acute medically ill patients: a cross-sectional study
BMJ Open, 11 (11), e052428
DOI 10.1136/bmjopen-2021-052428, PubMed 34815283

Gamboa D, Jørgenrud B, Bryun EA, Vindenes V, Koshkina EA, Nadezhdin AV, Kabashi S, Tetenova EJ, Berg T, Nyman AAT, Kolgashkin AJ, Petukhov AE, Perekhodov SN, Davydova EN, Lerdal A, Nordby G, Bogstrand ST (2020)
Prevalence of psychoactive substance use among acutely hospitalised patients in Oslo and Moscow: a cross-sectional, observational study
BMJ Open, 10 (9), e032572
DOI 10.1136/bmjopen-2019-032572, PubMed 32948540

Nadezhdin A, Joergenrud B, Tetenova E, Bryun E, Koshkina E, Petukhov A, Kolgashkin A, Kabashi S, Bogstrand ST (2020)
Predictors of tobacco smoking among acutely ill patients in a Moscow hospital: A cross-sectional study
Tob Prev Cessat, 6, 18
DOI 10.18332/tpc/117954, PubMed 32548355

Årving A, Høiseth G, Hilberg T, Trydal T, Husa A, Djordjevic A, Kabashi S, Vindenes V, Bogstrand ST (2020)
Comparison of the Diagnostic Value of Phosphatidylethanol and Carbohydrate-Deficient Transferrin as Biomarkers of Alcohol Consumption
Alcohol Clin Exp Res, 45 (1), 153-162
DOI 10.1111/acer.14503, PubMed 33164220

Kabashi S, Vindenes V, Bryun EA, Koshkina EA, Nadezhdin AV, Tetenova EJ, Kolgashkin AJ, Petukhov AE, Perekhodov SN, Davydova EN, Gamboa D, Hilberg T, Lerdal A, Nordby G, Zhang C, Bogstrand ST (2019)
Harmful alcohol use among acutely ill hospitalized medical patients in Oslo and Moscow: A cross-sectional study
Drug Alcohol Depend, 204, 107588
DOI 10.1016/j.drugalcdep.2019.107588, PubMed 31590131