IDENTIFICATION OF HAZARDOUS HARMFUL DRINKING AMONG SUBCRITICALLY INJURED PATIENTS

Objectives: To examine the relationship between a saliva alcohol test (SAT) and hazardous/harmful drinking, as measured by the Alcohol Use D isorders Identification Test (AUDIT), among a sample of subcritically injured patients. Methods: Patients (n = 78) seeking treatment for a s ubcritical injury were saliva-tested for alcohol and interviewed regar ding their drinking behaviors and related difficulties. Associations o f SAT values with AUDIT results were determined. Results: SAT results and hazardous/harmful drinking were not independent events (p < 0.001) . Estimates of sensitivity and specificity (using a dichotomous SAT re sult [greater than or equal to 4 mmol/L] to identify positive AUDIT pa tients) were 65.2% and 83.6%, respectively. SAT-positive people had si gnificantly higher AUDIT scores than did SAT-negative individuals (p < 0.0001). Patients experiencing assault-type injuries were much more l ikely to be SAT-positive than were patients incurring other types of i njury. Discriminant function analysis suggests that AUDIT scores can s uccessfully identify SAT-positive and SAT-negative patients; the analy sis accounted for 42.5% of the variance and correctly classified 84.6% of the sample. Conclusions: The use of an easy-to-administer, noninva sive, routine SAT, among patients presenting for a subcritical injury in a hospital ED, provides a mechanism for the identification of indiv iduals with a history of hazardous/harmful drinking. However, since di scrimination of hazardous/harmful drinking is imperfect, some caution is warranted when conducting such screening activities.