PubMed · 6907124
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1981. [Antialcohol propaganda].. https://pubmed.ncbi.nlm.nih.gov/6907124/
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Nearly half of all trauma beds are occupied by patients who were injured while under the influence of alcohol. Alcoholism plays such a significant role in trauma that efforts to reduce injury recurrence are unlikely to be successful if it remains untreated. An injury requiring hospitalization creates a unique opportunity to intervene and to motivate patients to alter their drinking behavior, thereby making trauma centers ideal sites to implement an alcohol screening, intervention, and referral program. However, despite emphasis on injury control and prevention, little has been done to incorporate alcohol intervention programs into care of the injured patient. Effective means of intervention exist that are consistent with the time, financial, and staffing constraints of trauma centers, and they should be implemented.
OBJECTIVE: To study the extent of recognition by referring doctors of drug and alcohol problems in patients referred to consultation-liaison psychiatry for any reason, and the factors associated with non-recognition. DESIGN: Comparison of referring doctors' reasons for referral and psychiatrists' DSM-III-R diagnoses in 2347 inpatients referred consecutively over three years, by means of the prospective MICROCARES clinical database used by the consultation-liaison psychiatry service of each hospital involved. SETTING: Four general teaching hospitals of Monash University. RESULTS: Psychiatrists considered a psychoactive substance use disorder diagnosis likely in 336 (14%) of the referred patients; referring doctors missed 188 (56%) of these, referring instead for "depression", "anxiety" and "suicide attempt evaluation". The factors correlating with this discordance included younger age, male sex, having a personality disorder diagnosed, and having attempted self-harm. CONCLUSIONS: The extent of the failure to identify drug and alcohol problems in patients in whom some psychological problem worthy of referral to psychiatry had been detected is symptomatic of the extent of this failure in medicine generally. Education and the use of screening procedures may lead to development of coherent drug and alcohol protocols in individual institutions.
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