This paper provides a review of emergency room (ER) studies on alcohol and injury, using representative probability samples of adult injury patients, and focuses on the scope and burden of the problem as measured by estimated blood alcohol concentration (BAC) at the time of the ER visit, self-report drinking prior to injury, violence-related injury and alcohol use disorders. A computerized search of the English-language literature on MEDLINE, PsychINFO and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) Alcohol and Alcohol Problems Science Database (ETOH) was conducted for articles published between 1995 and 2005, using the following key descriptors: (1) emergency room/emergency department/accident and emergency, (2) alcohol/drinking and (3) injuries (intentional and unintentional). Findings support prior reviews, with injured patients more likely to be positive for BAC and report drinking prior to injury than non-injured, and with the magnitude of the association substantially increased for violence-related injuries compared to non-violence-related injuries. Indicators of alcohol use disorders did not show a strong association with injury. Findings were not homogeneous across studies, however, and contextual variables, including study-level detrimental drinking pattern, explained some of the variation. This review represents a broader range of ER studies than that reported previously, across both developed and developing countries, and has added to our knowledge base in relation to the influence of contextual variables on the alcohol-injury relationship. Future research on alcohol and injury should focus on obtaining representative samples of ER patients, with special attention to both acute and chronic alcohol use, and to organisational and socio-cultural variables that may influence findings across studies. In-depth patient interviews may also be useful for a better understanding of drinking in the injury event and associated circumstances.
"It has been well documented that individuals with SUD are more prone to TBI through motor vehicle accidents, violence, or falls (Taylor et al., 2003). Thus SUD can increase the risk of TBI (Cherpitel, 2007; Taylor et al., 2003). "
"Of particular interest is the prevalence of risky single occasion drinking (RSOD) – so-called binge drinking – which is defined as having large number of drinks on a single occasion (Gmel et al., 2010). RSOD is common among younger men and is most commonly associated with accidents and assaults (Cherpitel, 2007). This has implications for treatment, in that interventions tackling both alcohol and violence may be more appropriate for some ED patients (Walton et al., 2010). "
[Show abstract][Hide abstract] ABSTRACT: In 2010/2011, there were over 21 million attendances at English Emergency Departments (EDs), of which 35% are estimated to be alcohol-related. Screening in EDs could have considerable impact in identifying alcohol use disorders and directing people to appropriate interventions. We aimed to describe the screening and profile of risky single occasion drinkers (RSOD) in Nottingham University Hospitals (NUH) NHS Trust ED. Routine admissions data and alcohol screening responses for each patient aged 18 years and over were accessed from the ED information system (EDIS) for a period of 12 months. Of the 99,728 presentations at ED, 55,564 (55.72%) were screened and, of these, 8131 (16.81%) screened positive for RSOD. Compared with those who screened negative, they were 2.63 times more likely to present with injuries. However, the majority (N ¼ 5389, 66.28%) said their current presentation was not related to alcohol consumption. Of those who screened RSOD positive only 1.75% accepted a referral for advice; the majority (85.29%) accepted an information leaflet. Improvements to the screening process are suggested, including potentially targeting screening, using an assessment that may in itself have an impact on drinking outcomes, and improving the relevance of leaflets and brief interventions to specific subgroups of patients.
Journal of Substance Abuse 11/2013; 18(6):484-491. DOI:10.3109/14659891.2012.698694
"Prior studies have revealed relatively high rates (~10–46%) of substance use disorders (SUDs) in ED samples (Cherpitel, 2007; Cunningham et al., 2009; D'Onofrio, Becker, & Woolard, 2006), and individuals with SUDs are up to three times more likely to use ED services than are those without a SUD (D'Onofrio et al., 2006). In terms of violence involvement, studies of ED samples have revealed relatively high rates of intimate partner violence (IPV) (~9–46%) (Alexandercilova et al., 2013; Cunningham et al., 2009; Hofner et al., 2005; Lipsky & Caetano, 2011; Walton et al., 2009a), with most studies focusing on partner violence victimization among female ED patients (Daugherty & Houry, 2008; Houry et al., 2008; Lipsky et al., 2005). "
[Show abstract][Hide abstract] ABSTRACT: The study examined clinical characteristics and treatment interests of individuals identified to have substance use disorders (SUDs) in an urban emergency department (ED) who reported past six-month history of violence or victimization. Specifically, participants were 1441 ED patients enrolled in a randomized controlled trial of interventions designed to link those with SUDs to treatment. To examine factors related to violence type, four groups based on participants' reports of violence toward others were created: no violence (46.8%), partner violence only (17.3%), non-partner violence only (20.2%), and both partner and non-partner violence (15.7%). Four groups based on participants' reports of victimization were also created: no violence (42.1%), victimization from partner only (18.7%), victimization from non-partner only (20.2%), and both partner and non-partner victimization (17.7%). Separate multinomial logistic regression analyses were conducted to examine which variables distinguished the violence and victimization groups from those reporting no violence or victimization. For violence toward others, demographic variables, alcohol and cocaine disorders, and rating treatment for psychological problems were higher for violence groups, with some differences depending on the type of violence. For victimization, demographic variables, having an alcohol disorder, and rating treatment for family/social problems were higher for violence groups, also with some differences depending on the type of violence. Findings from the present study could be useful for designing effective brief interventions and services for ED settings.
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