DETECTION OF ALCOHOL-USE IN ADOLESCENT PATIENTS IN THE EMERGENCY DEPARTMENT

Objectives: To examine 3 methods of detecting alcohol use among adoles cent patients visiting a Level-1 regional trauma center. Methods: Part 1 was a retrospective review of laboratory records and (13- to 19-yea r-old) patient medical records over the 1-year period from August 1993 to July 1994. Part 2 was a review of ICD-9 discharge diagnoses for th e same age range during the same 1-year period. Part 3 involved prospe ctive saliva alcohol testing of injured patients aged 13-17 years old. Results: Part 1: A total of 522 blood tests were conducted and 160 (3 0.6%) were positive for alcohol. More than one-third of the alcohol-po sitive sample had alcohol ingestion as the only reason for their visit s, i.e., they were uninjured. The alcohol-positive group was more like ly to be male and older. Part 2: A total of 99 alcohol-related dischar ge diagnoses were given to adolescent patients. Alcohol abuse was the most common diagnosis. With the 2 methods of detection combined, 186 p atients were identified. Part 3: A total of 119 saliva alcohol tests w ere conducted. One patient tested positive but had been identified whi le in triage as having used alcohol. Conclusion: In this study populat ion, approximately one-third of adolescent patients tested for alcohol as part of routine clinical care were alcohol-positive but were not n ecessarily given an alcohol-related diagnosis. Thus, studies determini ng rates of alcohol-positive adolescents treated in EDs should use mul tiple methods of detection. Universal testing does not appear to be wa rranted for all injured adolescent patients.