SCREENING FOR ALCOHOL-PROBLEMS IN THE EMERGENCY DEPARTMENT

Study objective: To evaluate the sensitivity and specificity of severa l alcohol screening instruments (CAGE, brief MAST, AUDIT, TWEAK, Histo ry of Trauma Scale) and other measures (breath alcohol analyzer readin g and reporting of drinking before the event), in an emergency departm ent population, against international Classification of Disease, revis ion 10 (ICD-10) criteria for harmful drinking and for alcohol dependen ce from the Composite International Diagnostic Interview (CIDI) by gen der, race, and injury status. Design: A probability sample of patients was subjected to breath alcohol analysis and interviewed (N=1,330.) S etting: University of Mississippi Medical Center. Results: Overall, th e TWEAK and AUDIT methods were the most sensitive, identifying 84% and 81%, respectively, of patients who were positive for alcohol dependen ce. Sensitivity was not as high for females, whites, or the noninjured . Sensitivities for the breath alcohol analysis and self-reported drin king were 20% and 29%, respectively. Conclusion: These data suggest th at the effectiveness of screening instruments varies by gender, race, and injury status and that positive breath alcohol analysis readings a nd reporting of drinking before the event are not good indicators of a lcohol dependence in this population.