Alcohol Use and Trauma: Prevention through Screening and Intervention

Key Investigator: Fred Rivara, M.D., M.P.H.
University of Washington Department of Pediatrics
Funding Source: Centers for Disease Control & Prevention

Researchers at Harborview Injury Prevention and Research Center have studied alcohol-related admissions to trauma centers since 1989. Their research has shown that excessive alcohol use, ranging from binge drinking to chronic alcohol dependence, is a leading risk factor for trauma center admission.  The study of this serious issue led them to suggest that clinicians capitalize on the ‘teachable moment’ that presents itself when a patient is admitted to a trauma center, providing increased incentive to change their alcohol use.

First instituted at Harborview Medical Center in Seattle, the alcohol screening and brief intervention program was found to significantly reduce subsequent alcohol use and decrease the chance of repeat trauma center admission by nearly 50%. If broadly implemented, the program could lead to a cost savings of $1.82 billion dollars annually in direct medical costs.  CDC funding allowed Harborview to gather valuable clinical and cost data that demonstrated the effectiveness of alcohol screening coupled with brief intervention in trauma settings. 

Leading this project were Injury Center investigators Jerry Jurkovich, M.D., chief of trauma service at Harborview and professor of surgery at the UW; Larry Gentilello, M.D., formerly of Harborview and now at the University of Texas, Southwestern; Frederick Rivara, M.D., M.P.H., professor of pediatrics and adjunct professor of epidemiology at the UW; Beth Ebel, M.D., MSc, M.P.H., associate professor of pediatrics and director of HIPRC, and Douglas Zatzick, M.D., and  associate professor of psychiatry and behavioral sciences at the UW.  Their work led to a recent mandate from the American College of Surgeons’ Committee on Trauma, the primary agency responsible for developing trauma center requirements, that all Level 1 trauma centers must screen injured patients for alcohol use, and provide an intervention for those who test positive.