Alcohol Screening in the Emergency Department

Alcohol has been shown to be a significant risk factor for injury. Emergency departments (EDs), where injured patients are treated daily, are a particularly appropriate setting for screening for alcohol use problems. However, physicians do not universally address alcohol’s role in injuries; reasons include the busy clinical environment of EDs, variable and changing state laws, physicians’ imprecise estimation of the scope of the problem, and patchy dissemination of information about measures for addressing alcohol issues. This new AAA Foundation report provides background information on alcohol-related injury, screening, and interventions, describes the Screening for Our Safety (SOS) project, and discusses the potential utility of SOS as a mechanism by which interested organizations could partner with emergency physicians to reduce impaired driving in their communities.

The SOS project created an online educational curriculum that was accessed by a majority of emergency physicians statewide. After completing the curriculum, participants reported that they would screen patients for alcohol use problems more often, and at follow-up they reported that they were screening injured patients more frequently. These self-reported changes were supported by findings from a review of medical records at two hospitals as well as by the number of reports of impaired drivers submitted to the Rhode Island DMV.

At the conclusion of the project, in the 6-month follow-up survey, 37% of responding physicians indicated an interest in taking part in statewide advocacy efforts in this area and provided their personal contact information. These physicians will form a useful advocacy partner to address impaired driving issues in our state. The SOS pro­gram has potential for educating emergency physicians in other states on alcohol and injury, impaired driving, and screening for alcohol use problems as well as for creating partnerships for advocacy efforts to reduce impaired driving.