title: Substance use and posttraumatic stress disorder symptoms in trauma center patients receiving mandated alcohol screening and brief intervention.
abstract: In an effort to integrate substance abuse treatment at trauma centers, the American College of Surgeons has mandated alcohol screening and brief intervention (SBI). Few investigations have assessed trauma center inpatients for comorbidities that may impact the effectiveness of SBI that exclusively focuses on alcohol. Randomly selected SBI eligible acute care medical inpatients (N=878) were evaluated for alcohol, illegal drugs, and symptoms consistent with a diagnosis of posttraumatic stress disorder (PTSD) using electronic medical record, toxicology, and self-report assessments; 79% of all patients had one or more alcohol, illegal drug, or PTSD symptom comorbidity. Over 70% of patients receiving alcohol SBI (n=166) demonstrated one or more illegal drug or PTSD symptom comorbidity. A majority of trauma center inpatients have comorbidities that may impact the effectiveness of mandated alcohol SBI. Investigations that realistically capture, account for, and intervene upon these common comorbid presentations are required to inform the iterative development of college policy targeting integrated substance abuse treatment at trauma centers.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Harborview Injury Prevention and Research Center, University of Washington School of Medicine, Seattle, 98104, USA. dzatzick@u.washington.edu
authors.forename: Douglas
authors.initials: D
authors.lastname: Zatzick
authors.forename: Dennis
authors.initials: D
authors.lastname: Donovan
authors.forename: Christopher
authors.initials: C
authors.lastname: Dunn
authors.forename: Joan
authors.initials: J
authors.lastname: Russo
authors.forename: Jin
authors.initials: J
authors.lastname: Wang
authors.forename: Gregory
authors.initials: G
authors.lastname: Jurkovich
authors.forename: Frederick
authors.initials: F
authors.lastname: Rivara
authors.forename: Lauren
authors.initials: L
authors.lastname: Whiteside
authors.forename: Richard
authors.initials: R
authors.lastname: Ries
authors.forename: Larry
authors.initials: L
authors.lastname: Gentilello
mesh_terms: D000328:Adult; D000368:Aged; D019973:Alcohol-Related Disorders / Q000150:complications / Q000534:rehabilitation*; D000437:Alcoholism; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D017831:Diagnosis, Dual (Psychiatry); D057286:Electronic Health Records; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D011614:Psychotherapy, Brief / Q000379:methods*; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000628:therapy*; D019966:Substance-Related Disorders / Q000150:complications / Q000534:rehabilitation*; D014193:Trauma Centers; D055815:Young Adult