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Identifying people at greatest risk of substance use and related harms post\u2010release would help to target support at those most in need. The Alcohol Smoking and Substance Involvement Screening Test (ASSIST) is a validated substance use screener, but its utility in predicting substance\u2010related hospitalisation post\u2010release is unestablished. We measured whether screening for moderate\/high\u2010risk substance use on the ASSIST was associated with increased risk of substance\u2010related hospitalisation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A prospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Prisons in Queensland and Western Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Participants were incarcerated and within 6\u00a0weeks of expected release when recruited. A total of 2585 participants were followed up for a median of 873\u2009days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Baseline survey data were combined with linked unit record administrative hospital data. We used the ASSIST to assess participants for moderate\/high\u2010risk cannabis, methamphetamine and heroin use in the 3\u00a0months prior to incarceration. We used International Classification of Diseases (ICD) codes to identify substance\u2010related hospitalisations during follow\u2010up. We compared rates of substance\u2010related hospitalisation between those classified as low\/no\u2010risk and moderate\/high\u2010risk on the ASSIST for each substance. We estimated adjusted hazard ratios (aHR) by ASSIST risk group for each substance using Weibull regression survival analysis allowing for multiple failures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>During follow\u2010up, 158 (6%) participants had cannabis\u2010related, 178 (7%) had opioid\u2010related and 266 (10%) had methamphetamine\u2010related hospitalisation. The hazard rates of substance\u2010related hospitalisation after prison were significantly higher among those who screened moderate\/high\u2010risk compared with those screening low risk on the ASSIST for cannabis (aHR 2.38, 95% confidence interval [CI] 1.74, 3.24), methamphetamine (aHR 2.23, 95%CI 1.75, 2.84) and heroin (aHR 5.79, 95%CI 4.41, 7.60).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Incarcerated people with an Alcohol Smoking and Substance Involvement Screening Test (ASSIST) screening of moderate\/high\u2010risk substance use appear to have a significantly higher risk of post\u2010release substance\u2010related hospitalisation than those with low risk. Administering the ASSIST during incarceration may inform who has the greatest need for substance use treatment and harm reduction services in prison and after release from prison.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.16365","type":"journal-article","created":{"date-parts":[[2023,10,19]],"date-time":"2023-10-19T08:02:10Z","timestamp":1697702530000},"page":"236-247","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Using the Alcohol, Smoking and Substance Involvement Screening Test to predict substance\u2010related hospitalisation after release from prison: A cohort study"],"prefix":"10.1111","volume":"119","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2556-3294","authenticated-orcid":false,"given":"Craig","family":"Cumming","sequence":"first","affiliation":[{"name":"Centre for Health Services Research, School of Population and Global Health University of Western Australia  Crawley Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3956-5343","authenticated-orcid":false,"given":"Stuart A.","family":"Kinner","sequence":"additional","affiliation":[{"name":"Centre for Adolescent Health Murdoch Children's Research Institute  Parkville Australia"},{"name":"Melbourne School of Population and Global Health The University of Melbourne  Parkville Australia"},{"name":"Griffith Criminology Institute Griffith University  Mt Gravatt Australia"},{"name":"School of Population Health Curtin University  Perth Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2833-4830","authenticated-orcid":false,"given":"Rebecca","family":"McKetin","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre University of New South Wales  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5702-372X","authenticated-orcid":false,"given":"Jesse T.","family":"Young","sequence":"additional","affiliation":[{"name":"Centre for Adolescent Health Murdoch Children's Research Institute  Parkville Australia"},{"name":"Institute for Mental Health Policy Research Centre for Addiction and Mental Health  Toronto Canada"},{"name":"Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health The University of Melbourne  Parkville Australia"},{"name":"National Drug Research Institute Curtin University  Perth Australia"},{"name":"School of Population and Global Health University of Western Australia  Crawley Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Li","sequence":"additional","affiliation":[{"name":"School of Population and Global Health University of Western Australia  Crawley Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David B.","family":"Preen","sequence":"additional","affiliation":[{"name":"Centre for Health Services Research, School of Population and Global Health University of Western Australia  Crawley Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,10,19]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"Behind bars II: Substance abuse and America's prison population","author":"National Center on Addiction and Substance Abuse at Columbia University","year":"2010"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14555"},{"key":"e_1_2_10_4_1","volume-title":"The health of Australia's prisoners 2018","author":"Australian Institute of Health and Welfare","year":"2019"},{"key":"e_1_2_10_5_1","volume-title":"National Drug Strategy Household Survey 2016: detailed findings","author":"Australian Institute of Health and Welfare","year":"2017"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-2311.2011.00677.x"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-159-9-201311050-00005"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2015.06.011"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2013.9008"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2019.107707"},{"key":"e_1_2_10_11_1","unstructured":"HobbsM. 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