Alcohol, Injuries and the Emergency Department

Alcohol, Injuries and the Emergency Department

The Problem

Excessive alcohol consumption is an important factor in more than 100,000 deaths in the United States each year.

Between 20% and 30% of the patients seen in U.S. hospital emergency departments (ED) have alcohol problems.
Nearly half of alcohol-related deaths are the result of injuries from motor-vehicle crashes, falls, fires, drowning, homicides, and suicides.
Emergency departments do not routinely screen patients for alcohol problems.

CDC's Accomplishments

Conference identified research and program needs
In March 2001, CDC's Injury Center and five federal partners sponsored a conference for researchers, practitioners and other stakeholders to review current knowledge about alcohol problems among emergency department patients. Participants identified critical research gaps, public and private sector support needed to close those gaps, and health care and public policy issues that directly affect service availability. They also developed a research agenda to improve availability and quality of screening and intervention for alcohol problems among ED patients.

Screening and brief intervention shows promise
Preliminary data from a CDC-funded study indicate that emergency department patients receiving screening and brief intervention for alcohol problems reduced their alcohol use. Between June 1999 and December 2000, CDC and the Center for Rural Emergency Medicine at West Virginia University enrolled almost 3,000 patients in a clinical trial to determine the efficacy of screening ED patients for alcohol problems and counseling those who screen positive. Forty-five percent of patients enrolled screened positive for alcohol problems. Researchers followed up with more than 1,100 patients after they had been enrolled in the study for three months.

Ninety-five percent of patients in the experimental group had received counseling for their alcohol problem. Researchers are currently conducting
a 12-month follow-up study to determine if the initial positive changes endure.

Computer-based intervention feasible in emergency departments
CDC funds researchers at the University of Michigan to develop and test an interactive computer-based intervention to prevent alcohol use and misuse among adolescents who come to the ED after an injury. Between October 1999 and March 2001, 640 patients ages 14 to 18 were recruited; most of them had sustained unintentional injuries. Adolescents were randomly assigned to intervention and control groups. Intervention participants attended a virtual party, chose a "party pal" to accompany them, and answered knowledge and behavior-related questions about alcohol use and misuse. Researchers are conducting follow-up telephone interviews with study participants 3 and 12 months after their ED visit to assess their alcohol use and misuse. Interim findings show that the intervention was well-received by adolescents, their parents, ED physicians, and ED staff. The follow-up interviews will show whether or not the intervention was effective in changing alcohol use and misuse among youth.

Future Steps

Alcohol problems, a known risk factor for a wide range of illnesses and injuries, are prevalent among patients in emergency departments. This fact makes the emergency department a logical setting in which to screen and intervene for alcohol problems. While ED-based screening and intervention has shown promise in ongoing studies, we should continue to explore this strategy for preventing alcohol-related injuries. The research agenda developed at the March 2001 conference (described previously) will help direct our efforts.

Just The Facts: Alcohol and Injuries

An alcohol-related motor vehicle crash kills someone every 33 minutes and nonfatally injures someone every two minutes.

In 1999, 15,786 people died in alcohol-related motor vehicle crashes. That's 38% of the year's total traffic deaths.
Approximately 1.4 million drivers were arrested in 1998 for driving under the influence of alcohol or narcotics. That's just over 1% of the estimated 120 million or more episodes of impaired driving that occur among U.S. adults each year.
About 3 in 10 Americans will be involved in an alcohol-related crash in their lifetimes.
Nearly three-quarters of drivers convicted of driving while impaired are either frequent heavy drinkers (alcohol abusers) or alcoholics (alcohol dependent).
The National Safety Council estimates that alcohol-related motor vehicle crashes cost the nation $26.9 billion in 1998.

This page last reviewed July17, 2002

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Centers for Disease Control and Prevention
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