The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #55959

N Freedner, MPH¹, R Saitz, MD, MPH², TP Palfai, PhD³, NJ Horton, ScD², and JH Samet, MD, MA, MPH². (1) Clinical Addiction Research and Education Unit, Boston Medical Center, Section of General Internal Medicine, 91 East Concord Street, Suite 200, Boston, MA 02118, 617 414 6928, naomi.freedner@bmc.org, (2) Clinical Addiction Research and Education Unit, Boston University Schools of Medicine and Public Health, Section of General Internal Medicine, 91 East Concord Street, Suite 200, Boston, MA 02118, (3) Department of Psychology, Boston University, 64 Cummington Street, Boston, MA 02215

Purpose: Professional organizations recommend screening for the spectrum of alcohol problems, from risky drinking to alcohol dependence. We assessed hospitalized medical patients and determined the prevalence of alcohol disorders in the course of evaluating a brief intervention (BI) for alcohol problems. Methods: We screened all available adult medical inpatients at an urban hospital between March 2001 and October 2002. Current hazardous drinking amounts were defined as >14 standard drinks/week or >=5 drinks/occasion for men, and >11 drinks/week or >=4 drinks/occasion for women, in the past 30 days. A sub-sample of hazardous drinkers who anticipated being available for follow up, who had no significant cognitive impairment, and who agreed to participate in a BI study, were assessed to determine alcohol diagnosis using the Composite International Diagnostic Interview. Results: Of 7,327 medical inpatients, 5,441 completed the screening; 1,029 (19%) were drinking hazardous amounts. The 245 sub-sample patients drank more (median 30 vs. 12 drinks/week), were more likely to report hazardous per occasion amounts (99% vs. 65%), and had higher Alcohol Use Disorders Identification Test scores (91% vs. 66% >=8) (all p<0.0001) than hazardous drinkers who did not participate in further evaluation. Most sub-sample patients had current alcohol dependence (79%) or abuse (4%); 48% had an alcohol-related medical diagnosis. Conclusions: Almost one-fifth of hospitalized medical patients report drinking hazardous amounts, but the majority of those willing to participate in a brief intervention (BI) are alcohol dependent. Hospitalized medical patients identified by alcohol screening who participate in BI tend to be late stage drinkers for whom the efficacy of BI remains to be established.

Learning Objectives:

At the conclusion of the session, the participant will be able to:
• define hazardous drinking,
• describe the severity of alcohol problems among hospitalized medical patients in an urban hospital, and
• Weigh the merits of implementing a screening and brief intervention program in this setting.

Keywords: Alcohol Use, Screening

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.