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Using PEth and AUDIT-4 to Detect Harmful Alcohol Use Among People with Severe Substance Use
Nina Auestad1,2,3, Benedicte Jørgenrud1, Stig Tore Bogstrand1,4
1Section of Forensic Research, Department of Forensic Science, Oslo University Hospital, Oslo, Norway.
Substance Use & Misuse
|May 13, 2026
Summary
Harmful alcohol use is common among people with severe substance use (PWSSU), particularly women. Addressing alcohol use alongside substance use treatment can reduce health risks in this vulnerable population.
Area of Science:
- Addiction Medicine
- Public Health
- Clinical Toxicology
Background:
- Severe substance use is linked to elevated mortality and reduced life expectancy.
- Concurrent harmful alcohol use exacerbates health risks in people with severe substance use (PWSSU).
- Harmful alcohol use is often overlooked in PWSSU populations.
Purpose of the Study:
- To assess the prevalence of harmful alcohol use among PWSSU.
- To identify factors associated with harmful alcohol use in this population.
Main Methods:
- 165 PWSSU were recruited from Oslo, Norway.
- Alcohol and substance use were assessed via questionnaires and blood tests (including PEth).
- Harmful alcohol use was defined using AUDIT-4 scores and PEth concentrations.
Main Results:
- 75% of participants reported alcohol use in the past 12 months.
- Harmful alcohol use was found in 24% of males and 47% of females.
- Female sex, younger age, and non-opioid primary substance use were associated with harmful alcohol use.
Conclusions:
- Harmful drinking patterns are prevalent among PWSSU, especially women.
- Reducing harmful alcohol use is crucial for mitigating health risks in PWSSU.
- Integrated treatment for substance and alcohol use is recommended for this population.
