title: The Emergency Department as a prevention site: a demographic analysis of substance use among ED patients.
abstract: OBJECTIVE
  To identify rates of alcohol and drug use among patients presenting to an inner-city Emergency Department (ED) and to describe demographic and health characteristics of patients with high-risk use.
  
  
  METHODS
  A cross-sectional study of patients presenting to the ED for any complaint. Patients were administered a brief screening about past 12-months alcohol and drug use. Patients who answered "yes" to any question were approached for a longer survey, the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST). Based on ASSIST scores patients received a brief intervention, and, when appropriate, a referral for brief outpatient therapy or specialized substance abuse treatment. Patients whose score indicated high-risk or dependent use were also asked demographic and health questions.
  
  
  RESULTS
  Over a 20-month period, 19,055 patients were pre-screened. 87.1% of patients were black, 57% were male, with average age 44.8 years. 27.6% of patients pre-screened positive for drug or alcohol use; among these patients 44.2% scored in the low-risk range on the ASSIST, 35.8% moderate risk, 10% high risk and 10% probable dependence. Among patients with high-risk or dependent use, 70% rated their current health as fair/poor, with a mean of 1.7 ED visits in the prior 30 days. 40.7% reported "extreme" stress due to their use. 34.6% reported that they had stable housing and 13.6% were fully employed.
  
  
  CONCLUSIONS
  Among all patients seen in the ED for any complaint, a significant proportion is engaged in alcohol and drug use that increases their risk of health and social consequences.
authors.affiliation: Emory University, Emergency Medicine, Decatur, GA 30032, United States. ahankin@emory.edu
authors.forename: Abigail
authors.initials: A
authors.lastname: Hankin
authors.forename: Mikyta
authors.initials: M
authors.lastname: Daugherty
authors.forename: Angela
authors.initials: A
authors.lastname: Bethea
authors.forename: Leon
authors.initials: L
authors.lastname: Haley
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D003625:Data Collection / Q000379:methods*; D003710:Demography / Q000379:methods*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D057566:Self Report; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control*