PROBLEM DRINKING IN EMERGENCY DEPARTMENT PATIENTS - THE SCOPE FOR EARLY INTERVENTION

Objective: To determine the prevalence of previously undiagnosed problem drinking and thereby to assess the suitability of the emergency department for early intervention. Design: Three hundred and fifty ambulatory care patients were assessed by means of a structured interview schedule, physical examination and blood tests. Alcohol intake and presence of alcohol-related problems were recorded, along with history of past advice on drinking and self-perception of an alcohol problem. Setting: The ambulatory care section of the emergency department of Royal Prince Alfred Hospital, Sydney. Patients: Three hundred and fifty subjects, aged between 18 and 55 years, were sequentially selected over an 18-month period. Results: Forty-one per cent of subjects (95% confidence interval, 36%-46%), 50% of men and 26% of women, were classified as problem drinkers on the basis of hazardous or harmful levels of alcohol consumption, frequent drinking to intoxication, evidence of dependence, or experience of alcohol-related problems. Of these, 63% had not previously received advice on drinking from a health professional and only 28% perceived they had a problem. Of particular note was that 24% of men and 4% of women were drinking 12 or more drinks (120 g of alcohol or more) in a single session on a weekly or more frequent basis. Conclusions: Many of the problem drinkers attending the emergency department have not previously received advice about their drinking from a health professional. The emergency department therefore offers considerable potential as a site for early detection and intervention in patients with hazardous and harmful alcohol use and related disorders.