During the 1990s, 100,000 Americans died each year because of alcohol abuse or alcohol dependence (ANAD). Alcohol is the third leading preventable cause of mortality in the U.S. AA/AD burdens U.S. emergency departments (EDs). The estimated prevalence of ANAD in trauma centers ranges between 25- 50% of patient populations. Persons who are AA/AD take up half of all trauma beds and consume more than 15% of the national health care budget. Also, ANAD are associated with chronic disease, crime, losses in workplace productivity, and a spectrum of social costs. The goal of this project is to translate motivational interventions, successful in primary care settings to the ED environment by implementing screening and brief intervention (SBIRT) and referral to treatment to reduce at-risk drinking among ED patients. Specific Objectives: To participate as a local site for the NIH-NIAAA sponsored 'National Alcohol Screening Day' (NASD) focused, multi-center study designed to test the effectiveness of SBIRT as practiced by ED physicians, nurses, and physician assistants as part of clinical care in the ED setting to reduce levels of hazardous drinking among ED patients. To use the publicity and materials for NASD, and the training provided by the 'Boston University ED Alcohol Education Project' to increase adoption of SBIRT by ED practitioners. Hypotheses: 1. Among persons identified with ANAD in the ED setting, SBIRT counseling Nill result in significantly decreased frequency and quantity of self-reported alcohol use, reduced alcohol related health risk factors, and increased completion of aftercare referrals in the intervention group as measured at 3 and 6 month follow-up, as compared to a control group of persons identified with AA/AD in the ED setting who receive only written advice as measured at 3 and 6 month follow-up. 2. ED personnel who receive SBIRT training, and self-report as having positive experiences during the intervention period surrounding NSAD, will adopt or enhance their SBIRT of patients with ANAD in the ED setting.
