Detection of Acute Alcohol Intoxication and Chronic Alcohol Dependence by Trauma Center Staff

Gentilello, Larry M.; Villaveces, Andrés; Ries, Richard; Nason, Katie S.; Daranciang, Elizabeth; Donovan, Dennis M.; Copass, Michael K.; Jurkovich, Gregory J.; Rivara, Frederick P.

doi:10.1097/00005373-199912000-00027

Cited by 96 publications

(66 citation statements)

References 32 publications

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“…We recommend that routine screening for substance abuse be included in comprehensive rehabilitation care, since as needed screening is likely to be biased. 44 Identification of drug and alcohol problems in this population may help identify patients who are at-risk for poorer rehabilitation progress and lower discharge functional independence 5 as well as those atrisk for decubitus ulcers and urinary tract infections. 7,8 Moreover, brief opportunistic interventions and strategic referrals may help reduce relapse.…”

Section: Resultsmentioning

confidence: 99%

Preinjury alcohol and drug use among persons with spinal cord injury: Implications for rehabilitation

Stroud

Bombardier

Dyer

et al. 2011

The Journal of Spinal Cord Medicine

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Context/objective: To describe preinjury alcohol and drug use and opportunities for secondary prevention among persons with recent spinal cord injury (SCI). Design: Survey. Setting: Acute inpatient rehabilitation program. Participants: Participants were 118 (84.8%) of 139 consecutive admissions who met inclusion criteria and were screened for preinjury alcohol and drug use. Interventions: None. Outcome measures: Alcohol and drug use, toxicology results, alcohol problems, readiness to change, and treatment preferences. Results: Participants were on average 37 years old, 84% were men, and 85% were white. Fifty-one percent of the sample was considered 'at-risk' drinkers. Significant lifetime alcohol-related problems were reported by 38% of the total sample. Thirty-three percent reported recent illicit drug use and 44% of the 82 cases with toxicology results were positive for illicit drugs. Seventy-one percent of at-risk drinkers reported either considering changes in alcohol use or already taking action. Forty-one percent reported interest in trying substance abuse treatment or Alcoholics Anonymous (AA). Motivation to change alcohol use was significantly and positively associated with self-reported indicators of alcohol problem severity. Conclusion: Preinjury alcohol and drug abuse are common among persons with recent SCI. Substance abuse screening is feasible and detects not only salient clinical problems but also significant motivation to change and interest in AA or treatment, all of which represent an important window of opportunity for appropriate brief interventions and referrals. In contrast with the idea that alcoholism is a 'disease of denial', the majority of atrisk drinkers with new onset SCI indicate they are considering making changes.Keywords: Alcohol, Drug, Substance-related disorders, Spinal cord injuries, Rehabilitation, Paraplegia, Tetraplegia, Toxicology screening Alcohol and drug abuse or dependence is a common comorbid condition among newly injured persons with spinal cord injury (SCI). Preinjury alcohol use and abuse has been shown to be higher among individuals who sustain SCI compared to the general population, with approximately one-third of newly injured persons with SCI reporting a history of alcohol-related problems.1 A significant proportion of persons with SCI report that preinjury alcohol or drug use contributed to their injury, 1 while estimates of intoxication at the time of injury range from 17 to 62%. 2-4Preinjury alcohol or drug use among persons with SCI has been associated with adverse medical and rehabilitation outcomes. Preinjury alcohol problems have been related to less functional independence at rehabilitation admission and discharge as well as slower progress during inpatient rehabilitation.5 Persons with SCI who have a history of problem drinking also report spending less time in productive activities (including rehabilitation therapies) during inpatient rehabilitation. 6History of preinjury alcohol and drug use predicts poorer Rates of post-injury alcohol abuse among pe...

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Section: Resultsmentioning

confidence: 99%

Preinjury alcohol and drug use among persons with spinal cord injury: Implications for rehabilitation

Stroud

Bombardier

Dyer

et al. 2011

The Journal of Spinal Cord Medicine

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show abstract

“…It has been reported that 10% to 23% of acute alcohol intoxication is not diagnosed upon clinical examination alone (2,24). Blood alcohol levels are the only means of quantifying the extent of intoxication.…”

Section: Discussionmentioning

confidence: 99%

Breath Analyzer Screening of Emergency Department Patients Suspected of Alcohol Intoxication

Sebbane

Claret

Jreige

et al. 2012

The Journal of Emergency Medicine

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“…Only four of the 16 categorical assessments were accurate, none of which included the legally intoxicated targets [22]. Physicians' and emergency nurses' ability to detect acute alcohol intoxication among trauma patients has also exhibited poor sensitivity (23% of patients with a BAC > 100 mg/dl were not identified) and specificity rates (patients were more likely to be falsely classified as intoxicated if young, male, disheveled, uninsured or having a low income) [23]. While physical manifestations (i.e.…”

Section: Sensitivity and Specificitymentioning

confidence: 99%

Methodological and practical limitations to visually determining intoxication

Barry

Dennis

2013

Addiction

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Detection of Acute Alcohol Intoxication and Chronic Alcohol Dependence by Trauma Center Staff

Abstract: Formal alcohol screening should be routine because clinical detection of acute alcohol intoxication and dependence is inaccurate. Screening should also be routine to avoid discriminatory bias attributable to patient characteristics.

Cited by 96 publications

References 32 publications

Preinjury alcohol and drug use among persons with spinal cord injury: Implications for rehabilitation

Preinjury alcohol and drug use among persons with spinal cord injury: Implications for rehabilitation

Breath Analyzer Screening of Emergency Department Patients Suspected of Alcohol Intoxication

Methodological and practical limitations to visually determining intoxication

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