The Emergency Department as a prevention site: A demographic analysis of substance use among ED patients

• Published in: Drug and alcohol dependence 2013-06, Vol.130 (1), p.230-233
• Main Authors: Hankin, Abigail, Daugherty, Mikyta, Bethea, Angela, Haley, Leon
• Format: Article
• Language: English
• Subjects: Adult; Alcohol Drinking - epidemiology; Alcohol Drinking - prevention & control; Cross-Sectional Studies; Data Collection - methods; Demography - methods; Emergency Department; Emergency Service, Hospital; Female; Humans; Male; Mass Screening - methods; Middle Aged; Prevention; Psychiatry; SBIRT; Self Report; Substance abuse; Substance-Related Disorders - diagnosis; Substance-Related Disorders - epidemiology; Substance-Related Disorders - prevention & control
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/j.drugalcdep.2012.10.027

Abstract Objectives To identify rates of alcohol and drug use among patients presenting to an inner-city Emergency Department (ED) and to describe demographic and health characteristics of patients with high-risk use. Methods A cross-sectional study of patients presenting to the ED for any complaint. Patients were administered a brief screening about past 12-months alcohol and drug use. Patients who answered “yes” to any question were approached for a longer survey, the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST). Based on ASSIST scores patients received a brief intervention, and, when appropriate, a referral for brief outpatient therapy or specialized substance abuse treatment. Patients whose score indicated high-risk or dependent use were also asked demographic and health questions. Results Over a 20-month period, 19,055 patients were pre-screened. 87.1% of patients were black, 57% were male, with average age 44.8 years. 27.6% of patients pre-screened positive for drug or alcohol use; among these patients 44.2% scored in the low-risk range on the ASSIST, 35.8% moderate risk, 10% high risk and 10% probable dependence. Among patients with high-risk or dependent use, 70% rated their current health as fair/poor, with a mean of 1.7 ED visits in the prior 30 days. 40.7% reported “extreme” stress due to their use. 34.6% reported that they had stable housing and 13.6% were fully employed. Conclusion Among all patients seen in the ED for any complaint, a significant proportion is engaged in alcohol and drug use that increases their risk of health and social consequences.