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Gail D'Onofrio, MD, MS, Tara McPartland, MSW, MPH, Samantha Moffett, and Linda Degutis, DrPH, MSN. Department of Surgery Section of Emergency Medicine, Yale University School of Medicine, 464 Congress Avenue, Suite 260, New Haven, CT 06519, 203 785-7590, gail.donofrio@yale.edu

BACKGROUND: The Project ASSERT model uses Health Promotion Advocates (HPAs) to provide screening, brief intervention and referral to treatment (SBIRT) for ED patients with alcohol and other drug (AOD) problems. SBIRT in the ED setting is effective in identifying AOD problems and timely linkage of patients to alcohol treatment programs (ATP).

OBJECTIVE: To determine if differences exist between patients referred to an ATP who enroll and those who do not enroll.

METHODS: We analyzed Project ASSERT data from 1999-2004. HPAs identify patients with alcohol problems and provide linkage to ATPs. Patients are contacted a month later to confirm enrollment.

RESULTS: 22,534 patients were screened for AOD problems. 45.1% (10,135) reported any alcohol consumption with 60.2% (6107) exceeding NIAAA guidelines. Of those, 47.5% were classified as at-risk and 52.5% as dependent drinkers. 44.3% (2707) of problem drinkers were referred to an ATP; 76.8% were male; mean age was 42.22 +/- 10.95. 60.1% (1594) were successfully contacted for follow-up and 86.2% (1404) enrolled in a program.

Patients who had arrangements made for treatment enrollment in the ED were significantly more likely to enroll than patients who were given referrals but were responsible for making their own arrangements (99.0% and 64.6%; p=.00). Men were more likely to enroll 79.2% than women 69.7% p=.38 and dependent drinkers were more likely to enroll (89.7%) than at-risk (82.9%) p=.00.

CONCLUSION: Enrollment into ATPs from an ED SBIRT program is high. Factors such as gender, type of referral, and severity of AOD problem may influence program enrollment.

Learning Objectives:

• 1. Describe the elements of a screening and brief intervention program for alcohol and other drugs.
• 2. Apply screening and brief intervention techniques to local emergency departments and primary care settings.
• 3. Identify barriers for patients in obtaining care for substance abuse problems.

Keywords: Substance Abuse Assessment, Substance Abuse Treatment

Related Web page: yalesurgery.med.yale.edu/em/research/

Presenting author's disclosure statement:

Not Answered