Patients admitted to emergency services for drunkenness: Moderate alcohol users or harmful drinkers?

Objective: Most of the patients admitted to hospital emergency services are drunk. Some of them may need specific treatment after acute intoxication r emits. At present, treatment for alcoholism is offered to less than 5% of t hese patients. The authors evaluated the biological markers carbohydrate-de ficient transferrin (CDT) and gamma -glutamyltransferase (GGT) in patients admitted for acute alcohol intoxication (per DSM-IV criteria) supported by blood alcohol assay. These tests distinguished between otherwise moderate a lcohol users who were acutely intoxicated and harmful drinkers or alcohol-d ependent patients. Method: The authors conducted an exhaustive survey 24 hours a day during 2 nonconsecutive months. The study involved 166 patients (124 men and 42 wome n) who were admitted for acute alcohol intoxication as a principal or addit ional diagnosis. Their blood was analyzed for alcohol, GGT, and CDT levels. The CAGE questionnaire was administered, and social and demographic data w ere collected. Results: About 80% of the population studied displayed elevated GGT or CDT levels (65.7% had CDT levels >60 mg/liter; 41.6% had GGT levels >65 IU/lite r). Less than 10% of the patients with acute alcohol intoxication revealed results in the normal range for both markers and a negative finding on the CAGE questionnaire. Conclusions: Patients admitted to emergency services with high blood alcoho l levels should not be assumed to be moderate drinkers. Any drunkenness sho uld be interpreted as a sign of likely harmful alcohol consumption or alcoh ol dependency requiring clinical and biological tests, including CCT and CD T assays. Specific treatment for alcoholism should be systematically offere d to these patients.