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Alcohol, Tobacco, and Drug Use Among Emergency Department Patients.

Drug and Alcohol Dependence 2014;138(1):32-38. [doi: 10.1016/j.drugalcdep.2014.01.025]

Pilar M. Sanjuan, PhD (University of New Mexico, SW Node), Samara L. Rice, PhD (University of New Mexico, SW Node), Katie Witkiewitz, PhD (University of New Mexico, SW Node), Raul N. Mandler, MD (National Institute on Drug Abuse (NIDA)), Cameron Crandall, MD, PhD (University of New Mexico, SW Node), Michael P. Bogenschutz, MD (University of New Mexico, SW Node).

The prevalence of alcohol, tobacco, and other drug (ATOD) use among emergency department (ED) patients is high and many of these patients have unrecognized and unmet substance use treatment needs. Identification of patients in the ED with problem substance use is not routine at this time. In this study, investigators examined screening data, including standardized measures of ATOD use (HSI, AUDIT-C, DAST-10), from 14,866 ED patients in six hospitals across the United States participating in the National Drug Abuse Treatment Clinical Trials Network protocol CTN-0047 ("Screening Motivational Assessment and Referral to Treatment in Emergency Departments (SMART-ED)"). Younger age, male gender, higher triage acuity, and other substance use severity were expected to be associated both with use versus abstinence and with severity of each substance use type. Negative binomial hurdle models were used to examine the association between covariates and these two elements.

Rates of use and problem use in the study sample were similar to or higher than other ED samples, confirming high rates of ATOD use in emergency department patients. The majority of other results were as expected, with younger age, male gender, and more problematic alcohol, tobacco, and/or other drug use generally being associated with more problematic use of each substance as well as greater likelihood of use of other substances as well. However, the association of age and gender with severity varied across substances, and triage level was found to be a poor predictor of substance use severity.

Conclusions: Better understanding of the demographic correlates of ATOD use and severity and the patterns of comorbidity among classes of substance can inform the design of optimal screening and brief intervention procedures addressing ATOD use among ED patients. Tobacco may be an especially useful predictor. (Article (Peer-Reviewed), PDF, English, 2014)

Keywords: Alcohol | Brief intervention | CTN platform/ancillary study | Emergency departments | Screening, Brief Intervention, Referral to Treatment (SBIRT) | Smoking | Drug and Alcohol Dependence (journal)

Document No: 1046, PMID: 24594289, PMCID: PMC4030520 (available 5/1/2014).

Submitted by CTN Dissemination Librarians, 2/19/2014.


Bogenschutz, Michael P. mail
Crandall, Cameron
Mandler, Raul N. mail
Rice, Samara L.
Sanjuan, Pilar M. mail
Witkiewitz, Katie
NIDA-CTN-0047 www

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Supported by a grant from the National Institute on Drug Abuse to the University of Washington Alcohol and Drug Abuse Institute.
The materials on this site have neither been created nor reviewed by NIDA.
Updated 6/2014 --
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