The detection of problem drinkers in the Accident & Emergency Department.

Abstract

SummaryDemographic, clinical and biochemical information relating to alcohol use was obtained from every patient aged 16 and over attending two Accident & Emergency (A & E) departments over a 2‐week period (1693 cases) in an attempt to identify characteristics of patients with alcohol‐related problems. Measurement of the Blood Alcohol Concentration (BAC) alone fails to detect the majority of heavy drinkers attending an A & E department and clinical assessment of drunkenness is not accurate in many cases. A combination of questionnaire and BAC measurement is more accurate. Many patients attend A & E departments in an inebriated state during the evening. However, many more, with alcohol problems, present at other times of the day. The latter are often sober, with none of the florid stigmata of physical, psychological, or social complications of alcohol abuse. Particular attention should be paid to male patients, those who claim to have been assaulted, those arriving by taxi and the unemployed. Casualty Officers should be advised to take a very brief alcohol history in such cases. Any patient thereby identified as having an alcohol‐related problem should be encouraged to discuss the issue at greater length with his or her general practitioner.