The Impact of Screening, Brief Intervention, and Referral for Treatment on Emergency Department Patients' Alcohol Use

Edward Bernstein, Judith Bernstein, James Feldman, William Fernandez, Melissa Hagan, Patricia Mitchell, Clara Safi, Robert Woolard, Mike Mello, Janette Baird, Cristina Lee, Shahrzad Bazargan-Hejazi, Brittan A. Durham, Kerry Broderick, Kathryn A. LaPerrier, Arthur Kellermann, Marlena M. Wald, Robert E. Taylor, Kim Walton, Michelle Grant-ErvinDenise Rollinson, David Edwards, Theodore Chan, Dan Davis, Jean Buchanan Marshall, Robert H. Aseltine, Amy James, Elizabeth Schilling, Khamis Abu-Hasaballah, Ofer Harel, Brigitte M. Baumann, Edwin D. Boudreaux, Ronald Maio, Rebecca Cunningham, Teresa Murrell, David Doezema, Michael Bauer, Deirdre Anglin, Adriana Eliassen, Marcus Martin, Jesse Pines, Leslie Buchanan, James Turner, Linda C. Degutis, Patricia Owens, Gail D'Onofrio

Research output: Contribution to journalArticlepeer-review

151 Scopus citations


Study objective: We determine the impact of a screening, brief intervention, and referral for treatment (SBIRT) program in reducing alcohol consumption among emergency department (ED) patients. Methods: Patients drinking above National Institute of Alcohol Abuse and Alcoholism low-risk guidelines were recruited from 14 sites nationwide from April to August 2004. A quasiexperimental comparison group design was used in which control and intervention patients were recruited sequentially at each site. Control patients received a written handout. The intervention group received the handout and a brief intervention, the Brief Negotiated Interview, to reduce unhealthy alcohol use. Follow-up surveys were conducted at 3 months by telephone using an interactive voice response system. Results: Of 7,751 patients screened, 2,051 (26%) exceeded the low-risk limits set by National Institute of Alcohol Abuse and Alcoholism; 1,132 (55%) of eligible patients consented and were enrolled (581 control, 551 intervention). Six hundred ninety-nine (62%) completed a 3-month follow-up survey, using the interactive voice response system. At follow-up, patients receiving a Brief Negotiated Interview reported consuming 3.25 fewer drinks per week than controls (coefficient [B] -3.25; 95% confidence interval [CI] -5.76 to -0.75), and the maximum number of drinks per occasion among those receiving Brief Negotiated Interview was almost three quarters of a drink less than controls (B -0.72; 95% CI -1.42 to -0.02). At-risk drinkers (CAGE <2) appeared to benefit more from a Brief Negotiated Interview than dependent drinkers (CAGE >2). At 3-month follow-up, 37.2% of patients with CAGE less than 2 in the intervention group no longer exceeded National Institute of Alcohol Abuse and Alcoholism low-risk limits compared with 18.6% in the control group (Δ 18.6%; 95% CI 11.5% to 25.6%). Conclusion: SBIRT appears effective in the ED setting for reducing unhealthy drinking at 3 months.

Original languageEnglish (US)
Pages (from-to)699-710.e6
JournalAnnals of emergency medicine
Issue number6
StatePublished - Dec 2007
Externally publishedYes

ASJC Scopus subject areas

  • Emergency Medicine


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