Detection of alcohol use in adolescent patients in the emergency department.
OBJECTIVE
To examine 3 methods of detecting alcohol use among adolescent patients visiting a Level-1 regional trauma center.


METHODS
Part 1 was a retrospective review of laboratory records and (13- to 19-year-old) patient medical records over the 1-year period from August 1993 to July 1994. Part 2 was a review of ICD-9 discharge diagnoses for the same age range during the same 1-year period. Part 3 involved prospective saliva alcohol testing of injured patients aged 13-17 years old.


RESULTS
Part 1: A total of 522 blood tests were conducted and 160 (30.6%) were positive for alcohol. More than one-third of the alcohol-positive sample had alcohol ingestion as the only reason for their visits, i.e., they were uninjured. The alcohol-positive group was more likely to be male and older. Part 2: A total of 99 alcohol-related discharge diagnoses were given to adolescent patients. Alcohol abuse was the most common diagnosis. With the 2 methods of detection combined, 186 patients were identified. Part 3: A total of 119 saliva alcohol tests were conducted. One patient tested positive but had been identified while in triage as having used alcohol.


CONCLUSIONS
In this study population, approximately one-third of adolescent patients tested for alcohol as part of routine clinical care were alcohol-positive but were not necessarily given an alcohol-related diagnosis. Thus, studies determining rates of alcohol-positive adolescents treated in EDs should use multiple methods of detection. Universal testing does not appear to be warranted for all injured adolescent patients.
Barnett
N P
NP
Center for Alcohol and Addiction Studies, Brown University, Providence, RI 02912, USA. nancy_barnett@brown.edu
Spirito
A
A
Colby
S M
SM
Vallee
J A
JA
Woolard
R
R
Lewander
W
W
Monti
P M
PM
D000293:Adolescent; D000435:Alcoholic Intoxication / Q000175:diagnosis* / Q000453:epidemiology / Q000378:metabolism; D003955:Diagnostic Tests, Routine; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D000431:Ethanol / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D012463:Saliva / Q000378:metabolism; D014481:United States; D014505:Urban Population
D000431:Ethanol