Detection of Alcohol Use in Adolescent Patients in the Emergency Department

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Abstract
Objectives: To examine 3 methods of detecting alcohol use among adolescent patients visiting a Level‐1 regional trauma center. Methods: Part 1 was a retrospective review of laboratory records and (13‐ to 19‐year‐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 the same age range during the same 1‐year period. Part 3 involved prospective saliva alcohol testing of injured patients aged 13—17 years old. Results: Part 1: A total of 522 blood tests were conducted and 160 (30.6%) were positive for alcohol. More than one‐third of the alcohol‐positive sample had alcohol ingestion as the only reason for their visits, i.e., they were uninjured. The alcohol‐positive group was more likely to be male and older. Part 2: A total of 99 alcohol‐related discharge diagnoses were given to adolescent patients. Alcohol abuse was the most common diagnosis. With the 2 methods of detection combined, 186 patients were identified. Part 3: A total of 119 saliva alcohol tests were conducted. One patient tested positive but had been identified while in triage as having used alcohol. Conclusion: In this study population, approximately one‐third of adolescent patients tested for alcohol as part of routine clinical care were alcohol‐positive but were not necessarily given an alcohol‐related diagnosis. Thus, studies determining rates of alcohol‐positive adolescents treated in EDs should use multiple methods of detection. Universal testing does not appear to be warranted for all injured adolescent patients.

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