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Alcohol problems among emergency department patients : proceedings of a research conference on identification and intervention, March 19–21, 2001, Arlington, Virginia

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      For two-and-one-half days in March 2001, emergency physicians, trauma surgeons, policymakers, psychologists, psychiatrists, epidemiologists, and alcohol researchers gathered to share information and perspectives on screening methods and interventions for emergency department (ED) patients with alcohol problems. After considering the current state of knowledge in the field, their goal was to design a research agenda that would improve our ability to identify and help these patients.

      For years, anecdotal reports from ED staff indicated that many patients had alcohol problems, and during the 1990s, systematic screening studies validated those reports. In 1990, the Institute of Medicine issued a landmark report recommending that patients in EDs and other medical settings be screened for a broad spectrum of alcohol-related problems and that screen-positive patients receive a brief intervention or a referral to specialized treatment. As the decade progressed, further evidence from controlled studies confirmed the efficacy of brief interventions for alcohol problems in primary care settings. The demonstrated efficacy of these interventions combined with their brief nature led to calls for emergency physicians to address alcohol problems among their own patients. Although increased interest led to ED-based research, early efforts were beset by the unique operational difficulties presented by the ED clinical setting. Increased interest was tempered by emergency physicians’ preference for treating acute conditions rather than underlying risk factors and the lack of controlled research on interventions in ED settings.

      Recognition of these circumstances led staff from the Centers for Disease Control and Prevention (CDC) to invite other federal agencies to support a national effort to summarize the current state of knowledge and consider important directions for research on screening and interventions for ED patients with alcohol problems. Five other agencies joined CDC to co-sponsor this conference: the Agency for Healthcare Research and Quality, the Health Care Financing Administration (now the Centers for Medicare and Medicaid Services), the National Highway Traffic Safety Administration, National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health, and the Center for Substance Abuse Treatment of the Substance Abuse and Mental Health Services Administration. A steering committee composed of agency representatives as well as emergency medicine, trauma surgery, and alcohol researchers was formed to plan the conference.

      Since research in this clinical setting was relatively new and included representatives from disciplines that do not normally collaborate, the committee structured the conference to allow ample time for both presentations and discussion. The committee commissioned presentations on four broad topics: 1) the role of emergency medicine in identifying and treating patients with alcohol problems; 2) screening ED patients for alcohol problems; 3) intervention strategies for ED patients with alcohol problems; and 4) strategic considerations for implementing preventive interventions in the ED. During the first two days of the conference, participants heard the commissioned presentations and responses from invited discussants and joined in discussions to evaluate what is known and to identify critical gaps in systematic research. On the last half day of the conference, the assembled group responded to draft research recommendations presented by the steering committee. After the conference concluded, CDC staff incorporated feedback from discussions into a revised set of research recommendations for steering committee input and approval.

      Suggested citation: Hungerford DW, Pollock DA, editors. Alcohol Problems Among Emergency Department Patients: Proceedings of a Research Conference on Identification and Intervention. Atlanta (GA): National Center for Injury Prevention and Control, Centers for Disease Control and Prevention; 2002.

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