Impact of a Brief Motivational Interview on Drinking Behaviors of At Risk Drinkers Screened in the Emergency Room

Alcohol Screening and Brief Intervention in the Emergency Department

Alcohol abuse is associated with injury, chronic illness, absenteeism from work, and social costs to families and communities. The goal of this project is to translate motivational interventions successful in the primary care setting to the Emergency Department (ED) environment by implementing screening, brief intervention and referral to treatment (SBIRT) in order to reduce at-risk drinking among ED patients.

To evaluate the effectiveness of SBIRT in the emergency room setting, ED patients meeting NIAAA criteria for high risk drinking were recruited from 14 sites nationwide (control group-Spring, 2004; intervention group-Summer, 2004). 26% of screened ED patients met inclusion criteria. All enrollees received a list of local referral resources. Intervention group patients also participated in a 15 minute negotiated interview and ED staff referred them directly for treatment if indicated. Enrollees completed 3-month follow-up surveys with a telephone Interactive Voice Response (IVR) system. A total of 1137 patients were enrolled across 14 sites (561 intervention, 576 control), with 62% male, 37% Black, and 38% White, and a mean age of 37. At baseline intervention-i and control-c groups were similar in demographic characteristics and number of drinks on a typical day (mean-i 5.00, mean-c 5.12) and maximum drinks on a given day in the past month (mean-i 7.51, mean-c 7.33). The 3 month follow-up rate was 62% (n=687); the 6 month follow-up rate was 52% (n=567). The 12 month follow up is currently underway.

Inclusion Criteria:

• Age 18+

• Communication in English or Spanish

• Met NIAAA criteria for "at-risk drinking":

  • for Men: 15 or more drinks/week, or 5 or more drinks on a single occasion
  • for Women: 8 or more drinks/week, or 4 or more drinks on a single occasion
  • Age 65 or over: 8 or more drinks/week or more than 1 drink per day

Exclusion Criteria:

• Requests detox or already in alcohol treatment program
• Abnormal mental status
• Too ill to give consent
• Unable to provide consent for other reasons
• Suicidal
• Employee or student of site institution (where required)
• Prisoner
• Inability to follow up