Alcohol Agencies Announce Academic Emergency Medicine Department Collaboration
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the Substance Abuse and Mental Health Services Administration (SAMHSA), today kicked off a major collaborative study that will investigate ways to screen, identify, and treat patients in hospital emergency departments for alcohol problems.
Academic emergency medical departments (EDs) at 14 institutions throughout the U.S. will participate in the study, the first to rely solely on ED personnel, rather than research staff, to conduct the screening and intervention.
"We are very excited about this important venture," said NIAAA Director Ting-Kai Li, M.D., "and are confident that it will advance our ability to offer treatment to significantly more individuals with alcohol problems. Hospital EDs offer a unique opportunity not available elsewhere for alcohol abuse screening, brief counseling, and referral."
"This new study complements SAMHSA's ongoing efforts to fund early intervention services in hospitals and other community-based settings," added SAMHSA Administrator Charles Curie. "These efforts can reorient many people away from behaviors that, unchecked, can lead to addiction. For example, screening and referral to appropriate services for people who were driving while intoxicated could prevent repeat traumas and save countless lives."
For as long as EDs have existed, physicians and nurses have encountered and helped individuals with alcohol problems. However, a recent report in the Archives of Internal Medicine concluded that the number of alcohol-related ED visits is approximately 3 times higher than previously estimated, based on physician documentation or patient disclosure of alcohol involvement.
Controlled clinical trials of screening, brief intervention, and referral have shown positive outcomes in decreasing or eliminating alcohol use, reducing injury rates, and reducing costs to society. The ED is an ideal setting in which to provide people who drink in harmful or hazardous patterns with a targeted intervention at the time of an adverse event-a situation sometimes referred to as a "teachable moment." This project will attempt to demonstrate that it is possible to conduct ED screenings for alcohol problems and increase the likelihood of intervening via brief interventions and referrals to appropriate alcohol treatment.
A total of approximately 1000 patients will participate in the study. At three- and six-month intervals following their initial ED visits, patients in both the treatment and control conditions will be interviewed by telephone to assess drinking behavior and alcohol-related health consequences (e.g., drunk driving, fights, etc.).
The screening of patients will coincide with this year's National Alcohol Screening Day (NASD) on April 8. The 14 emergency medical centers that will take part in the study are affiliated with the following institutions:
Boston University Brown University Charles R. Drew University Denver Health Medical Center Emory University Howard University Tufts University University of California, San Diego University of Medicine and Dentistry of New JerseyUniversity of Michigan University of New Mexico University of Southern California University of Virginia Yale University
Edward Bernstein, MD, of the Boston University School of Public Health will coordinate the training of ED site personnel through the development of a curriculum and training program. The curriculum uses innovative, interactive methods, including video-streaming, and incorporates input from major national Emergency Medical professional organizations, such as the Society for Academic Emergency Medicine, the American College of Emergency Physicians, and the Emergency Nurses Association.
Robert Aseltine, Ph.D. at the University of Connecticut Health Sciences Center in Farmington, CT is heading up the Data Coordinating Center for the project. Approximately 1000 patients from all 14 sites will be involved in the study. At three and six months following their ED visits, patients in both the treatment and control conditions will complete followup interviews by telephone using Interactive Voice Response (IVR) technology. Primary outcomes assessed will include drinking behavior and alcohol-related health consequences (e.g., drunk driving, fights, etc.).
Additional information about alcohol and alcohol abuse may be found at www.niaaa.nih.gov and www.samhsa.gov. Information about National Alcohol Screening Day is available at www.nationalalcoholscreeningday.org or 1-800-890-2200.