Pubdate: Sat, 07 Jun 2003
Source: Charleston Daily Mail (WV)
Copyright: 2003 Charleston Daily Mail
Contact:  http://www.dailymail.com/
Details: http://www.mapinc.org/media/76

STUDY FINDS WIDESPREAD SUBSTANCE ABUSE IN ER PATIENTS

KNOXVILLE, Tenn. -- One of four people entering Tennessee hospital 
emergency rooms has a drug or alcohol abuse problem, but it's rarely 
diagnosed or treated, a study published by the American College of 
Emergency Physicians concludes.

That translates into as many as 22 million patients a year in emergency 
rooms across the country, according to the report written by Dr. Ian 
Rockett and colleagues at the University of Tennessee.

"I think people who work in emergency rooms are well aware that many 
patients have drug problems," said Rockett, who recently left UT for West 
Virginia University. "But I don't think they are truly aware of the extent 
of it."

Why is drug and alcohol abuse among ER patients a concern? One reason is 
the effect on treatment -- masking symptoms of head injury, for instance, 
or leading to bad interactions with prescribed medicines, experts say.

But it's also a concern because "this group of patients do not go to 
primary care," said Dr. Gail D'Onofrio, an associate professor of surgery 
in emergency medicine at Yale University who has written extensively on the 
subject.

"If you don't pick them up (in the ER), they are going to come back and 
with more injuries and more problems," she said.

The study, published in the June issue of Annals of Emergency Medicine, is 
described as the first to assess both alcohol and psychoactive drug use, 
abuse and dependence in a statewide population.

The researchers studied 1,502 adults seeking emergency care at seven 
unidentified large and small hospitals across Tennessee from June 1996 to 
January 1997.

Through patient interviews and follow-up screening of saliva and urine, the 
researchers determined 27 percent of the patients needed substance abuse 
treatment.

Yet "a diagnosis of an alcohol or other drug-related problem was recorded 
in the charts of only 1.1 percent of the . . . patients," the researchers 
wrote.

Eight percent of the 1,502 patients surveyed said they received substance 
abuse treatment at some point in their lives, but only 3 percent of the 
patients determined to need treatment at that moment were getting it.

"We all see the same things. We all have the same concerns and we all feel 
our hands are tied, many times," said Dr. Larry Alexander, a spokesman for 
the 28,000-member American College of Emergency Physicians.

"The study was excellent and it pointed out a problem. But until there is 
money poured into offering a solution, the problem is going to continue," 
said Alexander, who also is medical director for Central Florida Regional 
Hospital near Orlando.
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MAP posted-by: Keith Brilhart