EDs not screening for substance abuse
EDs not screening for substance abuse
Have you ever had a gut instinct that a patient’s injury was related to alcohol abuse, but you said nothing because you had five other patients waiting to be seen? If so, you’re not alone: A new study says 27% of adult ED patients in Tennessee had unmet substance abuse needs that weren’t identified during their visit.1
In addition, researchers found that these patients were 81% more likely to be admitted and 46% more likely to have made an ED visit in the previous 12 months. If substance abuse problems were addressed in EDs, this would save significant time, resources, and costs, according to Ian Rockett, PhD, MPH, the study’s principal investigator and director of educational programs for the department of community medicine at West Virginia University in Morgantown.
"Our research clearly indicates that EDs are doing little screening," he says. "This may well be a national norm."
The first step is to identify, select, and implement screening instruments and intervention strategies that will work in your ED, says Rockett. He recommends asking EDs with successful substance abuse screening programs to share strategies.
Opportunities abound for emergency nurses to identify and help substance abusers, Rockett says.
"The ED visit itself can represent a teachable moment for a patient," he says. "However, obviously the nature and degree of involvement has to be balanced against regular nursing duties."
ED nurse or counselor can intervene
The way you handle substance abuse screening depends on your available resources, Rockett explains.
"If screening reveals alcohol involvement in an injury case, an emergency nurse could counsel the patient on the alcohol-injury link and its implications for further injury of greater severity," he says.
Another possible intervention would be to have the patient talk with a substance abuse counselor in the ED, says Rockett. "However, when it is evident that an ED patient has a chronic substance abuse problem, then the best course of action is for the patient to be referred to a special treatment facility following consultation with a trained counselor in the hospital," he adds.
Reference
- Rockett IRH, Putnam SL, Jia H, et al. Unmet substance abuse treatment need, health services utilization, and cost: A population-based emergency department study. Ann Emerg Med 2005; 45: 118-127.
Source
For more information on substance abuse screening, contact:
- Ian Rockett, PhD, MPH, Professor and Associate Chair, Director of Educational Programs, Department of Community Medicine, West Virginia University, P.O. Box 9190, Morgantown, WV 26506-9190. Telephone: (304) 293-5325. Fax: (304) 293-6685. E-mail: [email protected].
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